Giant gastric folds: differential diagnosis at US.
OBJECTIVE
To evaluate ultrasonographic (US) features in the differential diagnosis of giant gastric folds.


METHODS
One hundred sixty-five patients with giant gastric folds at transabdominal US examination (five with Ménétrier disease, 24 with anisakiasis, 61 with acute gastric mucosal lesion [AGML], 13 with gastric lymphoma, and 62 with scirrhous carcinoma) were examined. With 3-6-MHz curved and 5-11-MHz linear-array transducers, the authors evaluated gastric wall thickness, wall stratification, main thickened layer, echogenicity, and compressibility of the lesion in each case. The Fisher protected least-significant-difference method was used to compare statistically the thickness of the gastric wall among diseases.


RESULTS
Wall thickness of AGML was significantly (P <.001) less than that of anisakiasis, gastric lymphoma, and scirrhous carcinoma. US findings revealed regular gastric wall thickening of the second or third layer, with preservation of wall stratification in all patients with benign conditions. The fourth layer was thickened only in patients with malignancy. The echogenicity of gastric lymphoma was markedly lower than that of any other condition. Compressibility of scirrhous carcinoma was absent, whereas it was well preserved in all benign conditions.


CONCLUSIONS
Transabdominal US can depict gastric wall stratification and is a useful noninvasive modality for differential diagnosis of giant gastric folds.
Okanobu
Hideharu
H
Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Japan.
Hata
Jiro
J
Haruma
Ken
K
Hara
Mutsuhiro
M
Nakamura
Kenjiro
K
Tanaka
Shinji
S
Chayama
Kazuaki
K
D002293:Adenocarcinoma, Scirrhous / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017129:Anisakiasis / Q000000981:diagnostic imaging; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005758:Gastritis, Hypertrophic / Q000000981:diagnostic imaging; D005773:Gastroscopy; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000000981:diagnostic imaging*; D013272:Stomach Diseases / Q000000981:diagnostic imaging; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging; D014463:Ultrasonography