title: Advanced gastric carcinoma with signet ring cell carcinoma versus non-signet ring cell carcinoma: differentiation with multidetector CT.
abstract: OBJECTIVE
  The purpose of this study is to assess the capability of multidetector computed tomography (MDCT) to assist in the differentiation of advanced gastric carcinoma with signet ring cell type from that with non-signet ring cell carcinoma (NSRC) with a focus on the thickened stomach wall itself.
  
  
  METHODS
  We retrospectively reviewed MDCT results in 80 patients with pathologically proven advanced gastric carcinoma with signet ring cell carcinoma (SRC) (n = 35) and NSRC (n = 45). MDCT images of 80 patients were analyzed retrospectively on gross appearance of thickened gastric wall (polypoid/fungating/ulcerative/diffuse infiltrative), predominantly thickened layer (inner/outer), contrast-enhancement pattern (nonlayered/layered) and degree of enhancement (high/moderate/low).
  
  
  RESULTS
  The most common type of gross appearance in both carcinomas was fungating, and the more common contrast-enhancement pattern in both carcinomas was a nonlayered pattern. The predominantly thickened layer was a high attenuation inner layer in both carcinomas. High-degree contrast enhancement was more common in SRC (37.1% of patients) than NSRC (15.6% of patients) with statistically significant difference (P = 0.01).
  
  
  CONCLUSIONS
  Multidetector CT cannot distinguish SRC from NSRC based on the thickened stomach wall alone. But, high-degree contrast enhancement was more common in advanced gastric carcinoma with SRC than that with NSRC.
authors.affiliation: Department of Diagnostic Radiology, Ajou University Hospital, College of Medicine, South Korea.
authors.forename: Jei Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Ki Whang
authors.initials: KW
authors.lastname: Kim
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Yu
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Seok Woo
authors.initials: SW
authors.lastname: Yang
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000368:Aged; D018279:Carcinoma, Signet Ring Cell / Q000000981:diagnostic imaging* / Q000473:pathology*; D003937:Diagnosis, Differential; D018450:Disease Progression; 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 / Q000379:methods