Sonography of the stomach: an in vitro study to determine the anatomic cause of inner hyperechoic and hypoechoic layers of the gastric wall.

Abstract
Sonography of the normal gastric wall delineates five distinct layers: from the luminal side, a first, inner hyperechoic layer; a second, hypoechoic layer; a third, middle hyperechoic layer; a fourth, hypoechoic layer; and a final, outer hyperechoic layer. The anatomic origin of the inner two sonographic layers has been a matter of controversy. To verify the histologic origin of the inner two sonographic layers, we attempted to correlate sonographic and histologic layers of resected gastric specimens. Because we hypothesized that the fluid covering the mucosa and the mucosa may be responsible for the sonographic inner two layers of the stomach, we selected specimens in which the mucosa was sloughed or thickened.

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