Wall thickening of the gastric antrum as a normal finding: multidetector CT with cadaveric comparison

The purpose of this study was to establish the normal range of wall thickness and the normal appearance of the gastric antrum on multidetector CT (MDCT).

AND MATERIALS. Soft-copy measurements of the gastric antrum and gastric body were performed on contrast-enhanced MDCT scans in 153 consecutive patients without gastric disease. For comparison, anatomic dissection of the stomach was performed in three cadavers.

Smooth thickening of the distal gastric antrum relative to the proximal stomach on MDCT was seen in 152 (99%) of 153 patients and appeared concentric in 96% and eccentric in 4%. The mean (+/- SD) antral wall thickness was 5.1 +/- 1.6 mm. The longitudinal extent of antral wall thickening averaged 4.6 cm. At least one antral wall measurement (anterior or posterior) exceeded 5 and 10 mm in 85 patients (56%) and seven patients (5%), respectively. The anterior wall of the gastric body was significantly thinner at 2.0 +/- 0.4 mm (mean +/- SD) than the wall of the gastric antrum (p << 0.0001). The mean antral wall thickness when distention was characterized as grade 1 (least), 2, 3, and 4 (most) was 6.9, 5.1, 4.9, and 4.0 mm, respectively. Linear submucosal low attenuation (mural striation) of the thickened portion of the gastric antrum was noted in 36 patients (24%); fat attenuation was present in 14 cases. Cadaveric stomachs showed mild segmental thickening of the distal gastric antrum, but this thickening was less pronounced compared with in vivo MDCT findings.

Smooth wall thickening of the distal gastric antrum relative to the proximal stomach on MDCT with or without submucosal low attenuation is a normal finding. Antral wall thickness commonly exceeds 5 mm and may measure up to 12 mm. Our MDCT findings, in conjunction with previous anatomic and physiologic observations, suggest that normal antral wall thickening consists of both static and dynamic components.