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from Section 9 - Gastrointestinal tract
Published online by Cambridge University Press: 05 November 2011
Imaging description
The normal gastric antrum commonly measures over 5 mm and may measure as much as 12 mm in thickness at CT (Figures 54.1 and 54.2) [1].
Importance
Misinterpretation of antral wall thickening as inflammation or tumor may lead to unnecessary treatment or investigation.
Typical clinical scenario
Smooth thickening of the gastric antrum was seen in 152 of 153 (99%) consecutive patients without gastric disease undergoing CT [1]. The antral wall thickness exceeded 10 mm in seven patients (5%). Linear submucosal low attenuation (mural stratification) of the thickened portion of the gastric antrum was noted in 36 patients (24%), and in 14 of these cases the low density appeared to be of fat attenuation.
Differential diagnosis
Wall thickening of the gastric antrum is often misinterpreted as “antral gastritis”. However, in a controlled study there was no association between antral wall thickness and Helicobacter pylori infection [2], and a prior study that suggested such an association lacked a control group, so the result may have been spurious [3].
Teaching point
Wall thickening of the gastric antrum is usually a normal finding and should not be misinterpreted as indicating inflammation or tumor.
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