Advanced gastric carcinoma with signet ring cell carcinoma versus non-signet ring cell carcinoma: differentiation with multidetector CT.
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.
Lee
Jei Hee
JH
Department of Diagnostic Radiology, Ajou University Hospital, College of Medicine, South Korea.
Park
Mi-Suk
MS
Kim
Ki Whang
KW
Yu
Jeong-Sik
JS
Kim
Myeong-Jin
MJ
Yang
Seok Woo
SW
Lee
Yong Chan
YC
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