Differentiating malignant from benign wall thickening in postoperative stomach using helical computed tomography: Results of multivariate analysis

Ji Yang Kim, Se Hyung Kim, Jeong Min Lee, Joon Koo Han, Jae Young Lee, Byung Ihn Choi

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

OBJECTIVE: To determine significant computed tomography (CT) predictors for differentiating malignant from benign wall thickening in postoperative stomach. METHODS: Sixty-nine patients with perianastomotic wall thickening (25 malignant, 44 benign) after gastric surgery were identified. All patients underwent contrast-enhanced CT with the administration of oral contrast agents such as air, diluted barium, or water. Two radiologists analyzed CT images regarding enhancement of thickened wall, obliteration of wall layering, heterogeneity, asymmetry, perigastric infiltration, proximity to metallic suture material, lymphadenopathy, adjacent bowel thickening, and periceliac soft-tissue density. Another radiologist measured the wall thickness and the mean CT value of the lesion and normal mucosa. Individual CT findings relevant as predictors were determined using the univariate test. Multivariate analysis was used to determine the most predictable factors. RESULTS: Malignant wall thickening was significantly thicker than benign one. Isoattenuation and high attenuation of thickened wall were more frequently seen in malignant than in benign cases. Multivariate analysis showed that isoattenuation or high attenuation of thickened wall, proximity to suture material, and perigastric infiltration were only 3 variables that independently differentiated malignant from benign thickening in postoperative stomach. CONCLUSION: Isoattenuation or high attenuation of thickened wall, perigastric infiltration, and wall thickening without metallic suture material are the 3 main factors distinguishing malignant from benign thickening in postoperative stomach.

Original languageEnglish
Pages (from-to)455-462
Number of pages8
JournalJournal of computer assisted tomography
Volume31
Issue number3
DOIs
StatePublished - 1 May 2007

Keywords

  • CT
  • Neoplasm
  • Postoperative
  • Stomach

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