The Radiopaedia Reading Room Podcast 9. Abdominal radiology with Michael Hartung and Matt Morgan
Mar 20, 2023
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Avoid Overcalling Gastric Wall Thickening
- When unsure about stomach wall thickening, view the stomach in multiple planes and assess enhancement patterns.
- Call abnormality only if thickening is evident in more than one plane and shows abnormal enhancement compared with background mucosa.
Use Negative Contrast For Gastric Staging
- Use negative oral contrast (eg. water) for CT staging of gastric cancer to distend the stomach and reveal mucosal enhancement.
- Avoid positive contrast for mucosal assessment because it obscures subtle enhancement differences.
Practice Patterns Shape Oral Contrast Use
- Institutional practice drives oral contrast use for acute abdominal CTs, and patterns persist over years.
- Oral contrast can help with problem solving and anatomical distinction but is being used less in emergency departments.