Sonographic assessment of the gastric wall

Abstract

Based on experimental data, the thickness of normal stomach wall was found to range from 2 to 6 mm with a reduction by 1 mm following increasing distention of the organ. Using a 3.5 and a 5 MHz linear applicator 5 sonographic layers of the stomache wall could be objectivated under experimental and clinical conditions contrary to his-under experimental and clinical conditions contrary to histologic structures. By stepwise dissection and comparison with histologic specimens, the hyperdense zones 1 and 5 (starting from the mucous membrane) could be identified as borderline echoes, whereas the hyperdense zone 3 was proven to represent the submucous layer, the hypodense zone 2 the mucous membrane and the hypodense zone 4 the muscularis propria layer.Stomache wall diameters exceeding 6 mm were proven to be pathologic. Peptic ulcers and carcinomas both appeared sonographically as unspecific multiforme wall thickening without normal layer patterns, whereas pertinent differentiating criteria could not be found—neither in respect of ulcer vs. carcinoma nor of early cancer (excavated type) vs. erosive gastritis. in polypoid lesions a limitation of pathologic patterns to the hypodense zone 2 (mucous membrane) without invasion of underlying layers was seen. Stomache wall phlegmon and stomache wall edema both appeared as homogeneous wall infiltrations caused by swelling of the hyperdense zone 3 (submucous layer). In reactive hypertrophy, stomache wall thickening caused by increase of the hypodense zone 4 (muscle layer) was found.