Mucinous versus nonmucinous gastric carcinoma: differentiation with helical CT.
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.
Park
Mi-Suk
MS
Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei Univ College of Medicine, Seoul, South Korea.
Yu
Jeong-Sik
JS
Kim
Myeong-Jin
MJ
Yoon
Sang-Wook
SW
Kim
Se Hoon
SH
Noh
Tae Woong
TW
Lee
Kwang-Hun
KH
Lee
Jong Tae
JT
Yoo
Hyung Sik
HS
Kim
Ki Whang
KW
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
D003287:Contrast Media