[Benign and malignant gastric ulcer: CT findings]

Area of Science:

• Radiology
• Gastroenterology
• Oncology

Background:

• Gastric ulcers present a diagnostic challenge, requiring accurate differentiation between benign and malignant etiologies.
• Computed tomography (CT) is a valuable imaging modality for evaluating gastrointestinal pathology.

Purpose of the Study:

• To assess the differential diagnostic value of CT findings in distinguishing benign from malignant gastric ulcers.
• To identify specific CT features indicative of malignancy in gastric ulcerative lesions.

Main Methods:

• Retrospective review of CT scans from 54 patients with histologically confirmed gastric ulcerative lesions (47 malignant, 7 benign).
• Analysis of CT parameters including lesion size, localization, wall thickness, contrast enhancement, perigastric tissue, lymphadenopathy, and liver metastases.
• Standardized CT protocol involving helical scanning, intravenous contrast, and gastric distension.

Main Results:

• Ulcer size and location were not significant for differential diagnosis.
• Malignant ulcers frequently showed focal wall thickening (>5mm), extension into the stomach body, contrast enhancement, perigastric abnormalities, lymphadenopathy, and liver metastases.
• Benign ulcers typically lacked these features, though early malignant lesions could mimic benign findings.

Conclusions:

• CT is effective in identifying gastric ulcers and differentiating benign from malignant types.
• Specific CT findings like focal wall thickening, lesion enhancement, and distant metastases strongly suggest malignancy.
• Absence of these findings is characteristic of benign ulcers but requires careful evaluation for early-stage malignancy.