Enhancing Pattern of Gastric Carcinoma at Dynamic Incremental CT: Correlation with Gross and Histologic Findings

Shin, Hong Seop; Lee, Dong Ho; Kim, Yoon Hwa; Ko, Young Tae; Lim, Joo Won; Yoon, Yup

Abstract

PURPOSE
To evaluate the enhancing pattern of gastric carcinomas at dynamic incremental CT and to correlate it with pathologic findings.
MATERIALS AND METHODS
We retrospectively evaluated the enhancement pattern of stomach cancer on dynamic incremental CT of the 78 patients. All the lesions had been pathologically proved aftersurgery. The enhancement pattern was categorized as good or poor in the early phase ; homogeneous, heterogeneous or ring enhancement ; the presence or absence of delayed enhancement. There were 16 cases of early gastriccancer(EGC), and 62 cases of advanced gastric cancer(AGC). The Borrmann type of AGC were 1(n=1), 2(n=20), 3(n=32),4(n=8) and 5(n=1). The histologic patterns of AGC were tubular(n=49), signet ring cell(n=10), and mucinous(n=3). The enhancing patterns were compared with gross and histologic findings and delayed enhancement was corrrelated with pathologic evidence of desmoplasia.
RESULTS
Good enhancement of tumor was seen in 24/41cases (58.5%) with AGC Borrmann type 3-5, in 6/21(28.6%) with AGC Borrmann type 1-2, and in 3/16(18.8%) with EGC (P<.05). By histologic pattern, good enhancement of tumor was seen in 8/10(80%) with signet ring cell type, in 21/49(42.9%)with tubular type, and in 1/3(33.3%) with mucinous type(P<.05). EGC was homogeneously enhanced in 14/16cases(87.5%), but AGC was heterogeneously enhanced in 33/62(53.2%), respectively(P<.01). There was no significant correlation between delayed enhancement and the presence of desmoplasia.
CONCLUSION
AGC Borrmann type 3-5 andsignet ring cell type have a tendency to show good enhancement and EGC is more homogeneously enhanced at dynamicincremental CT.