Ultrasonographic diagnosis of submucosal tumors of the stomach: The “bridging layers” sign

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Abstract
The ultrasonic findings in 14 cases with submucosal tumors and one case with extragastric lymphoma using the fluid-filled stomach method were reviewed to determine the appearance of the stomach wall in submucosal tumors. Two characteristic ultrasound features of submucosal tumors were demonstrated in all 14 lesions except in two located high in the fundus of the stomach. One feature was mucosal bridging layers, i.e., three layers could be seen on the mucosal side of the tumors, and at least two of them continued to layers 1 and 2 of the normal gastric wall. The other was a serosal bridging layer, i.e., layer 5 of the normal gastric wall ran toward the serosal side of the tumor. On the basis of a "bridging layers" sign, we believe a definite diagnosis of submucosal tumor can be obtained from ultrasound images.