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    PEMERIKSAAN RADIOLOGI PADA GASTRITIS DAN ULKUS-edited2017

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    shrt gt
    This document discusses various imaging modalities used to investigate gastritis and ulcers, including plain radiography, barium studies, ultrasound, CT, and MRI. It describes what normal and abnormal findings may appear on these exams for different gastrointestinal conditions like acute and chronic gastritis, peptic ulcers, and gastrointestinal neoplasms. Common abnormalities seen include thickened folds, erosions, ulcers, masses, strictures, and other anatomical deformities or irregularities. The location and appearance of findings can provide clues to determining specific diagnoses.

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    PEMERIKSAAN RADIOLOGI PADA GASTRITIS DAN ULKUS-edited2017

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    shrt gt
    94 views51 pages
    This document discusses various imaging modalities used to investigate gastritis and ulcers, including plain radiography, barium studies, ultrasound, CT, and MRI. It describes what normal and abnormal findings may appear on these exams for different gastrointestinal conditions like acute and chronic gastritis, peptic ulcers, and gastrointestinal neoplasms. Common abnormalities seen include thickened folds, erosions, ulcers, masses, strictures, and other anatomical deformities or irregularities. The location and appearance of findings can provide clues to determining specific diagnoses.

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    This document discusses various imaging modalities used to investigate gastritis and ulcers, including plain radiography, barium studies, ultrasound, CT, and MRI. It describes what normal and abnormal findings may appear on these exams for different gastrointestinal conditions like acute and chronic gastritis, peptic ulcers, and gastrointestinal neoplasms. Common abnormalities seen include thickened folds, erosions, ulcers, masses, strictures, and other anatomical deformities or irregularities. The location and appearance of findings can provide clues to determining specific diagnoses.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    94 views51 pages

    PEMERIKSAAN RADIOLOGI PADA GASTRITIS DAN ULKUS-edited2017

    Uploaded by

    shrt gt
    This document discusses various imaging modalities used to investigate gastritis and ulcers, including plain radiography, barium studies, ultrasound, CT, and MRI. It describes what normal and abnormal findings may appear on these exams for different gastrointestinal conditions like acute and chronic gastritis, peptic ulcers, and gastrointestinal neoplasms. Common abnormalities seen include thickened folds, erosions, ulcers, masses, strictures, and other anatomical deformities or irregularities. The location and appearance of findings can provide clues to determining specific diagnoses.

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    of 51

    IMAGING INVESTIGATION OF

    GASTRITIS AND ULCERS

    dr. Mashuri, Sp.Rad.,M.Kes

    12th Block Lecture


    GI System
    Semester IV
     Plain
    photo-BNO (Blass = Kandung Kemih, Nier = Ginjal,
    Overzicht = Pemeriksaan)
     Maag-Duodenography (MD) atau Oesophago-Maag-
    Duodenography (OMD)
     USG

     CT scan abdomen
     MRI

    IMAGING INVESTIGATION
    Barium Meal (OMD), Double Contrast
    (Supine Position) Supine Position:
    Note Barium Distribution
    in the Fundus due to
    gravity

    Angular Notch
    Incisura Angularis

    Antrum Body
    Barium Meal

    DJJ: Barium Meal


    Normal Position= Left side

    Angular Notch
    Incisura Angularis
    Duodenal Cap

    Pyloric Canal

    2nd Part of
    Duodenum

    3rd Part of Body Jejunum:


    Duodenum Plica Circularis on the
    Antrum outer border

    Ileum

    Barium
    Follow-Through
    CT scan abdomen VS OMD
    7
    GASTROINTESTINAL
    INFLAMMATION
     Mucosal changes
     Direct and Indirect evaluation
     Evaluate lumen and effect on lumen
     Degree of mucosal involvement determines the imaging findings
     Superficial – little effect
     Penetrating – affect adjacent areas

    GASTROINTESTINAL INFLAMMATION
     Superficial process
     Little imaging finding
     Spasm
     Mucosal edema and irregularity
     Penetrating process
     Ulcer development
     Perforation
     Adjacent inflammatory process

    GASTROINTESTINAL INFLAMMATION
     Acute gastritis
     Chronic gastritis

    GASTROINTESTINAL INFLAMMATION
     Gastritisinflammation of gastric mucosa
     Etiology: infection H. pylori (most common)
     Transient inflammation
     Bleeding and erosion
     Sloughing of mucosa

    ACUTE GASTRITIS
     Mucosal atrophy
     Intestinal metaplasia
     No-erosion (usually)
     Epithelial changes maydysplasiabasis for carcinoma
     Most important etiologic associationH. pylori

    CHRONIC GASTRITIS
     OMD
     US
     CT ABD

    IMAGING
     Location: Gastric antrum on
    crests of rugal folds
     Multiple punctate or slit-like
    collections of barium
     Erosions surrounded by
    radiolucent halos of
    edematous, elevated mucosa
     Scalloped or nodular antral
    folds
     Epithelial nodules or polyps
    (chronic)

    EROSIVE GASTRITIS, COMPLETE OR VARIOLIFORM


    EROSIONS (MOST COMMON TYPE)
     Thickened folds, spasm or decreased distensibility
     Scalloped or lobulated folds oriented longitudinally or transverse
    folds
     Crenulation or irregularity of lesser curvature
     Prolapse of antral mucosa through pylorus

    ANTRAL GASTRITIS
     Location: Antrum, body, or occasionally fundus; diffuse or
    localized
     Thickened, lobulated gastric folds
     Enlarged areae gastricae (≥ 3 mm in diameter)

    H. PYLORI GASTRITIS
     Location: Fundus and
    body
     Markedly thickened,
    lobulated gastric folds

    HYPERTROPHIC GASTRITIS
     Narrowed, tubular, nondistensible
    stomach
     Smooth, featureless mucosa, ↓ folds

    ATROPHIC GASTRITIS
     Craters (ulcers) extending to below the muscularis mucosa of
    stomach/duodenum
     Chronic, most often solitary lesions
     Duodenum (initial position 4:1)
     Stomach (antrum)
     GE junction
     Duodenum, stomach, and or jejunum

    PEPTIC ULCER DISEASE


    GASTRIC ULCER

     Barium projection from lesser curve –


    ulcer crater (arrow)
     Line of edema (arrowheads)
    GASTRIC ULCER
    *

     Overhead film with ulcer on greater


    curve (arrows)
     Lucent halo of edema base of ulcer
    (arrowhead)
     Ulcer extends outside expected mucosal
    margin
     Incidental note of contrast in gallbladder
    (*)
    PYLORIC CHANNEL ULCER

     Spot film
     Projection of barium from pyloric
    channel
     Edematous halo
     Barium collection just beyond the
    duodenal bulb greater curve aspect
    (large arrow)
     Probable small ulcer lesser curve aspect
    as well (small arrow)

    POST-BULBAR DOUDENAL ULCER


     Ulcer mound
    Incisula defect
    Chronic duodenal ulcer : Deformity of the duodenal bulb from fibrotic healing
    - Cloverleaf deformity (A) : symmetric narrowing of the midportion of the bulb with
    dilatation of the inferior and superior recesses at the base of the bulb (arrow)
    - Pseudodiverticulum (B) : asymmetric narrowing of the bulb
     Both benign and malignant origins
     Primary imaging techniques include barium

    GI NEOPLASM
    ESOPHAGEAL NEOPLASM

     Narrowing of mid esophagus


     Irregular mucosa (arrows)
    ESOPHAGEAL
    CARCINOMA
    ESOPHAGEAL
    NEOPLASM
    ESOPHAGEAL CARCINOMA
    NEOPLASM IN STOMACH WALL

     Silhouette
     Tumor mass as a
    filling defect
    extending into
    barium column
    GASTROINTESTINAL STROMAL TUMOR
    WITH ULCERATION
    GASTRIC
    NEOPLASM
    SCIRRHOUS NEOPLASM STOMACH
    ULCERATING ANTRAL NEOPLASM
    GASTRIC LYMPHOMA DIFFUSE
    METASTATIC
    MELANOMA

     Filling defects in the


    antrum
     Aspiration of barium
     Irregular filling defect in the fundus of
    stomach (arrows)
     Space occupying

    STOMACH NEOPLASM
    LINITIS PLASTICA

     Diffusenarrowing
    of the proximal
    stomach
     Diffuse
    infiltration
    of lymphoma in
    the wall of the
    stomach
     No motion on
    fluoroscopy
     Diffuse narrowing of the proximal stomach
     Diffuse infiltration of lymphoma in the wall of the
    stomach
     No motion on fluoroscopy

    LINITIS PLASTICA
    THANK YOU

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