Park Mi-Suk, Yu Jeong-Sik, Kim Myeong-Jin, Yoon Sang-Wook, Kim Se Hoon, Noh Tae Woong, Lee Kwang-Hun, Lee Jong Tae, Yoo Hyung Sik, Kim Ki Whang
Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei Univ College of Medicine, Seoul, South Korea.
Radiology. 2002 May;223(2):540-6. doi: 10.1148/radiol.2232010905.
To assess the capability of helical computed tomography (CT) to assist in the differentiation between mucinous and nonmucinous gastric carcinomas, with a focus on the thickened stomach wall itself.
In 62 patients with pathologically proved mucinous (n = 21) or nonmucinous (n = 41) gastric carcinomas, contrast material-enhanced helical CT images were obtained. The gross appearance, contrast enhancement pattern, predominant thickened layer, and degree of enhancement were retrospectively evaluated. Statistical analyses were performed with Fisher exact, chi(2), and Student t tests. A P value of less than.05 was considered to indicate a statistically significant difference.
The most common type of gross appearance in both carcinomas was fungating: It occurred in 71% of patients with mucinous carcinomas and in 59% of patients with nonmucinous carcinomas. The next most common gross appearance type was ulcerative (24% of patients) in nonmucinous carcinomas and diffusely infiltrative (29% of patients) in mucinous carcinomas (P =.009). The most common contrast enhancement pattern was homogeneous (61% of patients) in nonmucinous carcinomas and layered (62% of patients) in mucinous carcinomas (P =.001). These findings were significantly different. The predominantly affected thickened layer was the high-attenuating inner layer or the entire layer (88% of patients) in nonmucinous carcinomas and the low-attenuating middle or outer layer (57% of patients) in mucinous carcinomas. Only two mucinous tumors showed miliary punctate calcifications in infiltrative lesions.
Helical CT may assist in distinguishing mucinous from nonmucinous gastric carcinoma, primarily on the basis of enhancement pattern, predominant layer of the thickened wall, gross appearance, and presence of calcifications.
评估螺旋计算机断层扫描（CT）在鉴别黏液性和非黏液性胃癌方面的能力，重点关注增厚的胃壁本身。
对62例经病理证实为黏液性（n = 21）或非黏液性（n = 41）胃癌的患者进行了对比剂增强螺旋CT检查。回顾性评估其大体表现、对比增强模式、主要增厚层和增强程度。采用Fisher精确检验、卡方检验和Student t检验进行统计学分析。P值小于0.05被认为具有统计学显著差异。
两种类型的癌最常见的大体表现类型均为蕈伞型：黏液性癌患者中71%出现该类型，非黏液性癌患者中59%出现该类型。其次常见的大体表现类型在非黏液性癌中为溃疡型（24%的患者），在黏液性癌中为弥漫浸润型（29%的患者）（P = 0.009）。最常见的对比增强模式在非黏液性癌中为均匀型（61%的患者），在黏液性癌中为分层型（62%的患者）（P = 0.001）。这些发现有显著差异。非黏液性癌主要受累的增厚层为高密度内层或全层（88%的患者），黏液性癌为低密度中层或外层（57%的患者）。只有两例黏液性肿瘤在浸润性病变中显示粟粒状点状钙化。
螺旋CT可能有助于鉴别黏液性和非黏液性胃癌，主要依据增强模式、增厚壁的主要层面、大体表现和钙化情况。
