The ultrasonic demonstration of gastric lesions

Fifteen cases of circumferential gastric antral disease identified by upper gastrointestinal (GI) series over a 12-month period were studied by a gray-scale ultrasound. In 93 per cent of the patients studied, a characteristic ovoid anechoic area containing a dense central collection of echoes was identified. The abnormality was located in the midline or slightly to either side, just dorsal to the inferior margin of the liver on longitudinal sections. The lesions studied included primary and secondary malignancy, lymphoma, corrosive gastritis, and granulomatous disease of childhood. In each instance a barium study of the stomach confirmed the location of the lesion. A prospective study of 50 normal individuals revealed one patient in whom the characteristic appearance was found at ultrasound and who subsequently had a normal upper GI series. Thus, although the ultrasound appearance of antral thickening may rarely be found in normal individuals, this characteristic appearance should strongly suggest gastric pathology, necessitating an upper GI series.