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Diffuse-type gastric cancer: specific enhancement pattern on multiphasic contrast-enhanced computed tomography

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the enhancement pattern of diffuse-type gastric cancers (DGCs) on multiphasic contrast-enhanced computed tomography gastrography (CECTG).

Methods and materials

We studied 21 consecutive clinically diagnosed DGC patients who underwent CECTG. Gastric distension was obtained using effervescent granules. CT images were obtained 40 s (arterial phase) and 240 s (delayed phase) after injection of a nonionic contrast material. Two radiologists reviewed the CT images and analyzed layers and enhancement patterns. The readers evaluated the enhancement degree (mild, moderate, or marked) and calculated CT attenuation values by placing circular regions of interest (ROIs) within each layer of the lesion. The CT findings of 11 operated cases were correlated with pathological results.

Results

Most lesions were double-layered in the arterial phase, with a moderately enhanced inner layer and a mildly enhanced outer layer, and single-layered in the delayed phase. The mean attenuation value of the inner layer (146 ± 32.8 HU) was significantly higher than that of the outer layer (80.4 ± 15.5 HU) in the arterial phase (p = 0.0001). In the pathological analysis, wall stratification was preserved in nine cases and not preserved in two cases.

Conclusion

Most DGCs showed a double-layered pattern in the arterial phase and a single-layered pattern with moderate enhancement in the delayed phase.

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Acknowledgements

This work was supported by JSPS KAKENHI grant number 16K10284.

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Authors and Affiliations

  1. Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan

    Daisuke Tsurumaru, Mitsutoshi Miyasaka, Toshio Muraki, Akihiro Nishie & Hiroshi Honda

  2. Advanced Imaging and Interventional Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan

    Yoshiki Asayama

  3. Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan

    Eiji Oki

  4. Anatomic Pathology and Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan

    Minako Hirahashi & Tomoyuki Hida

Authors
  1. Daisuke Tsurumaru
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  2. Mitsutoshi Miyasaka
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  3. Toshio Muraki
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  6. Eiji Oki
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  7. Minako Hirahashi
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  9. Hiroshi Honda
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Corresponding author

Correspondence to Daisuke Tsurumaru.

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Conflict of interest

The authors declare no conflict of interest associated with this manuscript other than the above grant. This study was approved by the institutional review board of our institution.

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Tsurumaru, D., Miyasaka, M., Muraki, T. et al. Diffuse-type gastric cancer: specific enhancement pattern on multiphasic contrast-enhanced computed tomography. Jpn J Radiol 35, 289–295 (2017). https://doi.org/10.1007/s11604-017-0631-1

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  • DOI: https://doi.org/10.1007/s11604-017-0631-1

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