Abstract：
PURPOSE:To report the computed tomography (CT) findings of acute peptic ulcer disease (PUD) and to evaluate the usefulness of contrast media for diagnosis. METHODS:This retrospective study included 51 patients diagnosed with acute gastric peptic ulcer by endoscopy. Using a κ analysis, two radiologists independently reviewed contrast-enhanced emergency CTs performed within 24 h of endoscopy. Evaluation findings included low-attenuation wall thickening, focal wall thickening, focal luminal outpouching, perigastric fat stranding, ascites, adjacent lymphadenopathy, and high-density gastric contents. Of the 51 patients, 48 underwent both non-contrast-enhanced and contrast-enhanced CT, and two radiologists also evaluated the presence or absence of these findings on a non-contrast-enhanced CT. McNemar's test was used to evaluate the contrast media's usefulness. RESULTS:Interobserver variability of perigastric fat stranding revealed substantial agreement between evaluators, and other findings had almost perfect agreement. High-density gastric contents were the most recognized findings (60%). Low-attenuation focal wall thickening and focal luminal outpouching were observed in relatively large numbers (~50%) of the cases on contrast-enhanced CT. The CT examinations using contrast media provided significantly higher detectability of low-attenuation wall thickening and focal luminal outpouching than CT examinations without using contrast media. CONCLUSION:Acute PUD can be suspected in patients with nonspecific abdominal symptoms in whom emergency CT shows high-density gastric contents, focal low-attenuation wall thickening, and/or focal luminal outpouching. Our study showed that contrast media are useful for diagnosis.
journal_name
Clin Imagingjournal_title
Clinical imagingauthors
Oyanagi K,Higuchi T,Yoshimura Ndoi
10.1016/j.clinimag.2020.10.044subject
Has Abstractpub_date
2020-11-05 00:00:00pages
77-82eissn
0899-7071issn
1873-4499pii
S0899-7071(20)30417-4journal_volume
71pub_type
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