Dynamic contrast-enhanced subtraction and delayed MRI of gastric tumors: radiologic-pathologic correlation.
OBJECTIVE
Our goal was to determine whether dynamic MR subtraction images could be used to detect and stage gastric tumors.


METHODS
Dynamic MR subtraction images were prospectively performed in 20 patients without gastric lesions and in 39 patients with gastric tumors. The flat- or depressed-type early gastric cancers were excluded. The MR findings were assessed for layered pattern of the normal gastric wall, detectability of tumors, enhanced pattern of tumor, and depth of the tumor invasion. Surgical specimens were obtained from 30 of the patients with tumors, and histopathologic sections were made in the dynamic MR scanning direction.


RESULTS
The three-layered structure of the normal gastric wall was apparent in more of the dynamic MR subtraction images (60%) than of the nonsubtraction images (30%) in the control group. All 39 gastric tumors were detected by MRI. The intact inner layers overlying stromal tumors and outer layers interrupted by advanced gastric cancers were clear on the subtracted images. MRI accurately T-staged 88% of the gastric cancers.


CONCLUSIONS
Dynamic MR subtraction images can be used to identify gastric tumors and to stage gastric cancers.
Wang
C K
CK
Department of Radiology, Kaohsiung Medical University, Taiwan, ROC.
Kuo
Y T
YT
Liu
G C
GC
Tsai
K B
KB
Huang
Y S
YS
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013382:Subtraction Technique
D003287:Contrast Media