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Background: Dual-layer spectral-detector computed tomography (DLCT) may have the potential to evaluate gastric wall thickening. Purpose: To evaluate the efficacy of DLCT quantitative parameters in differentiating between benign and malignant thickening of the gastric wall. Material and Methods: A total of 58 patients with "gastric wall thickening" who underwent multi-phase abdominal enhanced DLCT scans were included in this study. Of these patients, 33 were malignant and 25 were benign. Parameters such as iodine concentration (IC), effective atomic number (Zeff), and attenuation of the lesions were measured during the arterial phase (AP) and venous phase (VP). Binary logistic regression was employed to calculate the combined prediction probabilities. The accuracy of the DLCT parameters was assessed using receiver operating characteristic (ROC) curves. Results: The values of IC, nIC, Zeff, normalized Zeff, and attenuation in the AP and VP were significantly higher (all P < 0.05) in the malignant group compared to the benign group. The ROC curves revealed that the IC, Zeff, and attenuation in the VP exhibited high diagnostic performance, with area under the ROC curve (AUC) values of 0.864, 0.862, and 0.840, respectively. The new combination of these three factors and gastric wall thickness had an AUC of 0.884, and the sensitivity and specificity were determined to be 81.8% and 92.0%, respectively. Conclusion: Spectral CT parameters, particularly the combination of gastric wall thickness, attenuation, IC, and Zeff in VP, have value in distinguishing between benign and malignant gastric wall thickening. [ABSTRACT FROM AUTHOR]

Postcontrast computed tomographic (CT) characteristics of gastrointestinal (GI) wall edema in humans have been described as GI wall thickening with a thickened submucosal layer and thin enhanced inner and outer layers. Published studies describing CT features of gastric wall edema in dogs are currently lacking. The aim of this retrospective, case series was to describe CT features of gastric wall edema in a group of dogs. Medical records were searched for dogs with postcontrast abdominal CT scans and a diagnosis of gastric wall edema based on histopathology (group I) or CT characteristics consistent with those reported in humans (group II). Clinical diagnosis, mean serum albumin concentration, and histopathological diagnosis were recorded. The following CT characteristics were recorded: numbers of wall layers, attenuation and contrast enhancement, presence of blood vessels, locations, distribution, and thickness. Twelve dogs (3 in group I and 9 in group II) were included. The most common clinical finding was hypoalbuminemia. In group I, a well‐defined three‐layer appearance with a non‐enhancing fluid‐attenuating middle layer was observed in three dogs and thin blood vessels in the middle layer in two dogs. In group II, nine dogs had a three‐layer appearance with a non‐enhancing fluid‐attenuating middle layer. Locations of gastric wall thickening were diffuse in two, focal concentric in six, and focal asymmetric in four dogs. Findings supported including gastric wall edema as a differential diagnosis for dogs with hypoalbuminemia and CT characteristics of a three‐layer appearance in the gastric wall, with a non‐enhancing fluid‐attenuating middle layer and thin blood vessels. [ABSTRACT FROM AUTHOR]

This report describes the radiological and endoscopic findings in a 54-year-old male who presented with epigastric pain. The patient underwent an upper gastrointestinal (GI) barium study followed by axial imaging, which demonstrated nodular gastric wall thickening. The classic findings of aggressive primary gastric diffuse large B-Cell lymphoma are presented with a brief review differentiating the pathological subtypes, important for patient prognostication and planning of therapy.

This report describes the radiological and endoscopic findings in a 54-year-old male who presented with epigastric pain. The patient underwent an upper gastrointestinal (GI) barium study followed by axial imaging, which demonstrated nodular gastric wall thickening. The classic findings of aggressive primary gastric diffuse large B-Cell lymphoma are presented with a brief review differentiating the pathological subtypes, important for patient prognostication and planning of therapy. [ABSTRACT FROM AUTHOR]

Abstract Background Ultrasonographic features of gastric wall edema have not been reported in dogs with hypoalbuminemia. Objectives To describe the prevalence and ultrasonographic features of gastric wall thickening in dogs with hypoalbuminemia and analyze correlation with serum albumin concentrations. Animals Forty‐two dogs with abdominal ultrasound and diagnosis of hypoalbuminemia (5 mm were considered gastric wall thickening. The gastric wall changes such as thickness, layering appearance, echogenicity, echotexture, distribution of lesions, and presence of peritoneal effusion were recorded. Serial ultrasonographic examination and histopathological findings were recorded if available. Mean serum albumin concentration of dogs with and without gastric wall thickening was compared. Results Prevalence of gastric wall thickening in dogs with hypoalbuminemia was 21.4% (95% confidence intervals 7.4‐35.4%). Mean gastric wall thickness was 10.0 ± 2.0 mm. Preserved mucosal layer and thickening of submucosal layer were observed in all 9 dogs. Five dogs had 3‐layer appearance in thickened submucosal layer. Diffuse wall thickening was observed in 6 dogs. All 9 dogs had peritoneal effusion. Subsequent changes of gastric wall thickening were observed in 3 dogs (range 4‐70 days). Gastric wall edema was confirmed histopathologically in 2 dogs via necropsy. There was no correlation between serum albumin concentration of the dogs and gastric wall thickness. Conclusions and clinical importance Findings indicated that gastric wall edema is a common finding in dogs with hypoalbuminemia. However, serum albumin concentrations did not correlate with the gastric wall thickness.

Plain radiography is a useful tool for distinguishing many intraabdominal pathologies and it rarely leads to a surprising diagnosis. Here, present a 12-year-old girl who presented with abdominal discomfort, dull pain and tenderness on palpation in the right upper quadrant, epigastrium and the right flank. Plain radiography showed an opacification due to gastric wall thickening. She was diagnosed with gastric ulcer, erosive gastropathy and duodenal ulcer based on findings of endoscopic examination. Her NSAID medication was ceased, and she was commenced on proton pump inhibitor. Her symptoms and radiological and endoscopic findings improved after two months of treatment. Gastric wall thickening seen on plain radiography as an opacified area is a rare evidence of peptic ulcer in children and may guide to choose endoscopy first instead of other modalities involving exposure to ionising radiation in further evaluation.

Abstract Background Gastric wall edema has not been reported as a complication of acute pancreatitis in dogs. Objective To describe the ultrasonographic features of gastric wall thickening in dogs with acute pancreatitis. Animals Fourteen dogs with ultrasonographic evidence and clinical diagnosis of acute pancreatitis, with ultrasonographic evidence of increased gastric wall thickness (>5 mm). Methods A retrospective search in the medical records from 2014 to 2016 was performed to identify dogs that had ultrasonographic evidence of acute pancreatitis, that had increased thickness of the gastric wall and that were diagnosed with acute pancreatitis clinically. The gastric wall changes such as thickness, layering appearance, echogenicity, distribution of lesions, and perigastric changes were recorded. Serial ultrasonographic examination and histopathological findings were recorded if available. Results Mean gastric wall thickness was 9.9 ± 4.0 mm (SD). A complete loss of wall layering was observed in 2 dogs. Thickening of the submucosal layer was observed in 12 dogs, and 5 of them had concurrent muscularis layer thickening. The echogenicity of thickened submucosal layer was intermediate hyperechoic. Lacy appearances were present within the thickened submucosal layer in 7 dogs and in the muscularis layer of 1 dog. Thickening was focal in 12 dogs and adjacent to the diseased pancreas. Subsequent resolution of gastric wall thickening was observed in 3 dogs (range 3‐28 days) via follow‐up ultrasound. One dog underwent necropsy, and gastric wall edema was confirmed histopathologically. Conclusions and Clinical Importance Findings indicated that gastric wall thickening presumably because of edema could be a complication of acute pancreatitis.

Background: Ultrasonographic features of gastric wall edema have not been reported in dogs with hypoalbuminemia. Objectives: To describe the prevalence and ultrasonographic features of gastric wall thickening in dogs with hypoalbuminemia and analyze correlation with serum albumin concentrations. Animals: Forty‐two dogs with abdominal ultrasound and diagnosis of hypoalbuminemia (<2.3 g/dL). Methods: Retrospective search in the medical records from 2018 to 2019 was performed. Ultrasound studies were reviewed and >5 mm were considered gastric wall thickening. The gastric wall changes such as thickness, layering appearance, echogenicity, echotexture, distribution of lesions, and presence of peritoneal effusion were recorded. Serial ultrasonographic examination and histopathological findings were recorded if available. Mean serum albumin concentration of dogs with and without gastric wall thickening was compared. Results: Prevalence of gastric wall thickening in dogs with hypoalbuminemia was 21.4% (95% confidence intervals 7.4‐35.4%). Mean gastric wall thickness was 10.0 ± 2.0 mm. Preserved mucosal layer and thickening of submucosal layer were observed in all 9 dogs. Five dogs had 3‐layer appearance in thickened submucosal layer. Diffuse wall thickening was observed in 6 dogs. All 9 dogs had peritoneal effusion. Subsequent changes of gastric wall thickening were observed in 3 dogs (range 4‐70 days). Gastric wall edema was confirmed histopathologically in 2 dogs via necropsy. There was no correlation between serum albumin concentration of the dogs and gastric wall thickness. Conclusions and clinical importance: Findings indicated that gastric wall edema is a common finding in dogs with hypoalbuminemia. However, serum albumin concentrations did not correlate with the gastric wall thickness. [ABSTRACT FROM AUTHOR]

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Background: Gastric wall edema has not been reported as a complication of acute pancreatitis in dogs. Objective: To describe the ultrasonographic features of gastric wall thickening in dogs with acute pancreatitis. Animals: Fourteen dogs with ultrasonographic evidence and clinical diagnosis of acute pancreatitis, with ultrasonographic evidence of increased gastric wall thickness (>5 mm). Methods: A retrospective search in the medical records from 2014 to 2016 was performed to identify dogs that had ultrasonographic evidence of acute pancreatitis, that had increased thickness of the gastric wall and that were diagnosed with acute pancreatitis clinically. The gastric wall changes such as thickness, layering appearance, echogenicity, distribution of lesions, and perigastric changes were recorded. Serial ultrasonographic examination and histopathological findings were recorded if available. Results: Mean gastric wall thickness was 9.9 ± 4.0 mm (SD). A complete loss of wall layering was observed in 2 dogs. Thickening of the submucosal layer was observed in 12 dogs, and 5 of them had concurrent muscularis layer thickening. The echogenicity of thickened submucosal layer was intermediate hyperechoic. Lacy appearances were present within the thickened submucosal layer in 7 dogs and in the muscularis layer of 1 dog. Thickening was focal in 12 dogs and adjacent to the diseased pancreas. Subsequent resolution of gastric wall thickening was observed in 3 dogs (range 3‐28 days) via follow‐up ultrasound. One dog underwent necropsy, and gastric wall edema was confirmed histopathologically. Conclusions and Clinical Importance: Findings indicated that gastric wall thickening presumably because of edema could be a complication of acute pancreatitis. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the diagnostic performance of unenhanced computed tomography (CT) for distinguishing gastric anisakiasis from non-anisakiasis gastric conditions and the reproducibility of CT findings. Methods: Fifty-six anisakiasis and 74 non-anisakiasis cases with gastric wall thickening on urgent observation using unenhanced CT were included. Using a κ analysis, two radiologists independently assessed the reproducibility of CT findings, including 'circumferential gastric wall thickening,' 'gastric wall thickening extending more than two segments,' 'bulky and low-density gastric wall thickening,' 'increase in peri-gastric fat density,' and 'ascites.' An anisakiasis diagnostic score (ADS) was developed for this study and was used to quantitatively evaluate the CT findings. An anisakiasis diagnostic prediction (ADP) with an appropriate cutoff value was used to further evaluate the ADS. Two radiologists reassessed the findings in consensus to determine the sensitivity, specificity, and accuracy of the CT findings, including the ADP and ADS area under the curve (AUC). Results: Considering reproducibility, a substantial agreement (0.6 < κ < 0.8) was achieved for all findings except 'circumferential gastric wall thickening' ( κ = 0.499), whereas for diagnostic performance, all findings except ascites were significantly more frequent among the anisakiasis cases. 'Bulky and low-density gastric wall thickening' had the highest sensitivity (98%), whereas 'gastric wall thickening extending more than two segments' had the highest specificity (80%). The ADP sensitivity, specificity, and accuracy were 91%, 84%, and 87%, respectively. The AUC was 0.902 ( p < 0.05). Conclusions: Unenhanced CT findings are useful for distinguishing anisakiasis from non-anisakiasis gastric conditions with sufficient reproducibility. [ABSTRACT FROM AUTHOR]

IgG4-related disease (IgG4-RD) is a recently designated disease entity and its full picture has not yet been elucidated. Here, we report an unusual case of a patient with gastric wall thickening secondary to IgG4-RD. A 68-year-old male visited our hospital with itchy skin lesions and an episode of organizing pneumonia. On the suspicion of malignancy-associated skin lesions, computed tomography (CT) was performed. The CT revealed prominent thickening of the gastric wall. Due to the possibility of malignancy, the patient underwent distal gastrectomy. Histopathological examination showed fibrosis of the submucosa and prominent thickening of the muscularis propria. Most of infiltrating cells were IgG4-positive plasma cells. Post-operative blood test revealed significantly high serum levels of total IgG and IgG4. Based on these histological features, the patient was given a definitive diagnosis of IgG4-RD. Further accumulation of cases like the present case that develop IgG4-RD with rare manifestations would lead to the elucidation of pathogenesis. [ABSTRACT FROM AUTHOR]

The usefulness of endoscopic ultrasonography (EUS) in patients who have gastric wall thickening in computed tomography (CT) is not clear. All patients referred for EUS due to thickened gastric folds on CT were included in this study. Esophagogastroduodenoscopy (EGD) followed by EUS was performed on all patients. Twenty-eight patients were enrolled in the study. The mean ± SD age was 50.8 ± 15.9 years, and 60.7% were male. Most patients (78.6%) had symptoms, and 10 patients (35.7%) were ultimately diagnosed with a gastric neoplasm. In all patients with a normal EGD (11 patients), the EUS was normal. Accuracy, specificity, sensitivity, positive predictive value, and negative predictive value of EUS for detecting a lesion in thickened wall stomach on CT were 89.3%, 88.8%, 90.0%, 81.8%, and 94.1%, respectively. In patients with a thickened gastric wall by CT, upper gastrointestinal endoscopy should be done before endoscopic ultrasonography, with ultrasonography reserved for those patients with an abnormal EGD. Endoscopic ultrasonography has good sensitivity for lesion detection in cases with an abnormal endoscopy, and the presence of gastric symptoms increases the likelihood of abnormal EUS. [ABSTRACT FROM PUBLISHER]

Background: Gastric cancer is the second leading cause of cancer death worldwide., Aims: In the benign and malign gastric pathologies, we measured the Apparent Diffusion Coefficient (ADC) value from the thickened section of the stomach wall. We assessed the diagnostic value of ADC and we wanted to see whether this value could be used to diagnose gastric pathologies., Study Design: This study has a prospective study design., Methods: A total of 90 patients, 27 with malign gastric pathologies 63 with benign gastric pathologies with Gastric Wall (GW) thickening in multidector CT, were evaluated by T2 weighted axial MR imaging and Diffusion-Weighted Imaging (DWI). Measurements were made both from the thickened wall and from the normal GW. Also, a new method called GW/spine ADC ratio was performed in image analysis. The value found after ADC measurement from the GW was proportioned to the spinal cord ADC value in the same section., Results: The ADC values measured from the pathological wall in patients with gastric malignancy (1.115 ± 0.156 x10-3 mm2/s) were significantly lower than the healthy wall measurements (1.621 ± 0.292 × 10-3 mm2/s) and benign gastric diseases (1.790± 0.359 x10-3 mm2/s). GW/spine ADC ratio was also lower in gastric malignancy group., Conclusion: ADC measurement in DWI can be used to distinguish between benign and malign gastric pathologies., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)