What Can a Gastric Ultrasound With Contrast Detect?

A gastric ultrasound with contrast is an advanced imaging technique that provides detailed visualization of the stomach and duodenal walls, helping to assess the extent of any lesions and their local invasion. This diagnostic method is especially useful for identifying the boundaries of abnormal tissue growth and determining the stage of tumors. Additionally, it can effectively detect several common gastrointestinal conditions such as gastritis, gastroptosis (stomach prolapse), gastric stones, and peptic ulcers.

Gastritis
In cases of acute gastritis, contrast-enhanced ultrasound may reveal diffuse thickening of the gastric mucosa, reduced echogenicity, a smooth mucosal surface, and clear layering of the stomach wall. Chronic gastritis typically affects the antrum and lesser curvature of the stomach. The affected mucosa may appear thickened, uneven, and contain small areas of increased echogenicity or bright spots.

Gastroptosis (Stomach Prolapse)
During the examination, if the lower edge of the stomach extends below the line connecting the iliac crests while the patient is in a sitting or standing position, this indicates gastroptosis. The contrast helps outline the stomach's position clearly when it is filled.

Gastric Stones
Patients with gastric calculi will show distinct hyperechoic masses within the stomach cavity during the ultrasound. These stones are often mobile and change position with alterations in body posture, making them easily identifiable through contrast imaging.

Peptic Ulcer
When performed on an empty stomach, gastric ultrasound with contrast can detect localized thickening of the gastric wall at the ulcer site, which appears hypoechoic. Once the stomach is filled, the surrounding area may show thickening of both the mucosal and submucosal layers. However, smaller and shallower ulcers might only exhibit limited wall thickening without deeper involvement.

Furthermore, gastric tumors can be better visualized using this technique, particularly in terms of identifying the base of the mass and determining its origin. In patients suspected of having gastric cancer, ultrasound findings often include abnormal wall thickening and heterogeneous low echogenicity patterns. It's important to note that individuals suspected of having gastrointestinal perforation, pyloric obstruction, or swallowing difficulties should not undergo this procedure due to potential complications.