Aspects of CT visualization of gastric abnormalities and preparation for the examination of the stomach: why there is no standard imaging protocol? (Review of the literature)

Aim: An analysis of international scientific publications summarizing current data on methodological approaches to CT imaging of stomach diseases, including aspects of patient preparation, scanning techniques, and the use of contrast media, depending on the clinical situation. Materials and methods. A search was conducted for scientific literature and clinical recommendations in the PubMed, Scopus and RSCI databases from 2019 to 2024, including quoting earlier primary sources, using the keywords: “CT gastrography" (CT gastrography), “gastric cancer" (stomach cancer), “right down decubitus" (position lying on the right side); “oral contrast", “gastrointestinal perforation", “gastrointestinal bleeding". 235 articles were analyzed, 60 of which were used to compile the review. The review includes publications reflecting various approaches to performing CT scans of the stomach in both routine and emergency medical care. Results. The presented review demonstrated the advantages of multispiral computed tomography in the diagnosis of stomach diseases in terms of accessibility, speed and versatility. However, there is no unified approach to patient preparation, especially regarding the choice of oral contrast agent and its volume. Insufficient certainty was noted in the indications for positive contrast. Data on increased sensitivity of MSCT in gastric cancer (differentiation of stages T4a and T4b) are presented when scanning the patient in the right­down decubitus position. Differences in intravenous contrast protocols for imaging tumors and emergency abdominal pathology are also considered. Conclusion. The lack of standardization of gastric CT protocols is due to both the heterogeneity of clinical tasks and the lack of consensus among specialists. The individualization of the research approach, depending on the diagnostic purpose, increases its information content, reduces the risk of diagnostic errors and contributes to the provision of faster and more accurate medical care for urgent conditions.