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Value of the dynamic and delayed MR sequence with Gd-DTPA in the T- staging of stomach cancer: Correlation with the histopathology

Title
Value of the dynamic and delayed MR sequence with Gd-DTPA in the T- staging of stomach cancer: Correlation with the histopathology
Authors
Kang B.C.Kim J.H.Kim K.W.Lee D.Y.Baek S.Y.Lee S.W.Jung W.H.
Ewha Authors
백승연이선화강병철
SCOPUS Author ID
백승연scopus; 이선화scopus; 강병철scopus
Issue Date
2000
Journal Title
Abdominal Imaging
ISSN
0942-8925JCR Link
Citation
vol. 25, no. 1, pp. 14 - 24
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background: To evaluate the usefulness of dynamic and delayed magnetic resonance (MR) imaging in the T-staging of stomach cancer and to compare the enhancement pattern of the cancerous lesion and the normal wall. Methods'. We performed MR imaging in 46 patients with stomach cancer (including four early gastric cancers and 42 advanced gastric cancers). Axial, sagittal, or coronal two-dimensional fast low-angle shot) MR images for the water-distended stomach were obtained with dynamic protocol, including precontrast images and images obtained 30, 60, 90, and 240-300 s after intravenous injection of the 0.1 mM Gd-DTPA/kg solution. We evaluated the thickness, interruption (or not) of the low signal intensity bands, and enhancement pattern of the cancerous wall and normal gastric wall. We prospectively evaluated the depth of cancer invasion, perigastric infiltration (extraserosal invasion), perigastric organ invasion, and regional lymph nodes and determined tumor staging on MR images. These MR evaluations including MR-determined staging were correlated with the surgicopathologic findings. Results: Stomach cancer was shown as having a thickened wall with a rapid enhancing pattern after intravenous Gd-DTPA administration. The mucosa (and/or submucosa) affected by stomach cancer showed an early enhancement pattern (30-90 s after Gd-DTPA administration) in 43 of 46 patients 93%). The normal gastric mucosa demonstrated a delayed peak enhancement pattern (>90 s after Gd-DTPA administration) in 29 of 46 patients (63%) and variable enhancement pattern in 17 of 46 patients (37%). An interrupted low signal intensity band or highly enhanced tumorous lesion penetrating through the gastric wall was seen in 17 of 19 pT3 patients (90%). Consistency between MR-determined staging and surgicopathologic staging occurred in three of four pT1 tumors (75%), 10 of 13 pT2 tumors (77%), 17 of 19 pT3 tumors (90%), and eight of 10 pT4 tumors (80%); overall accuracy was 83%. Overall accuracy of regional lymph node involvement, as determined by enhanced MR, was 52%; 24 of 46 node groups were positive. Conclusions: Dynamic and delayed MR imaging can be useful for predicting depth of cancer invasion, perigastric infiltration (extraserosal invasion), and perigastric organ invasion by gastric cancer.
DOI
10.1007/s002619910003
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의학전문대학원 > 의학과 > Journal papers
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