title: Mucinous versus nonmucinous gastric carcinoma: differentiation with helical CT.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei Univ College of Medicine, Seoul, South Korea.
authors: Mi-Suk
authors: MS
authors: Park
authors: Jeong-Sik
authors: JS
authors: Yu
authors: Myeong-Jin
authors: MJ
authors: Kim
authors: Sang-Wook
authors: SW
authors: Yoon
authors: Se Hoon
authors: SH
authors: Kim
authors: Tae Woong
authors: TW
authors: Noh
authors: Kwang-Hun
authors: KH
authors: Lee
authors: Jong Tae
authors: JT
authors: Lee
authors: Hyung Sik
authors: HS
authors: Yoo
authors: Ki Whang
authors: KW
authors: Kim
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media