Comparing MR Imaging and CT in the Staging of Gastric Carcinoma
Kyung-Myung Sohn1,
Jae Mun Lee1,
Sung-Yong Lee1,
Bo-Young Ahn1,
Seung-Man Park2 and
Kyoung-Mee Kim3
1
Department of Radiology, St. Mary's Hospital, The Catholic University of
Korea, College of Medicine, 62, Youido-Dong, Yongdungpo-Gu, Seoul 150-010,
Korea.
2
Department of General Surgery, The Catholic University of Korea, College of
Medicine, Seoul 150-010, Korea.
3
Department of Clinical Pathology, The Catholic University of Korea, College of
Medicine, Seoul 150-010, Korea.
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Fig. 1A. —54-year-old man with stage T3 gastric cancer. Axial unenhanced
(A) and contrast-enhanced (B) T1-weighted MR images and helical
CT scan (C) show concentric tumor with strong contrast enhancement in
gastric body. Extraluminal nodule of gastric tumor and infiltration in
adjacent fat (arrows, A and C) are well seen on
A and C. Note few enlarged lymph nodes in left perigastric
region (arrowheads, A and C). On B, demarcation
of gastric tumor and lymph nodes is blurred with motion artifact.
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Fig. 1B. —54-year-old man with stage T3 gastric cancer. Axial unenhanced
(A) and contrast-enhanced (B) T1-weighted MR images and helical
CT scan (C) show concentric tumor with strong contrast enhancement in
gastric body. Extraluminal nodule of gastric tumor and infiltration in
adjacent fat (arrows, A and C) are well seen on
A and C. Note few enlarged lymph nodes in left perigastric
region (arrowheads, A and C). On B, demarcation
of gastric tumor and lymph nodes is blurred with motion artifact.
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Fig. 1C. —54-year-old man with stage T3 gastric cancer. Axial unenhanced
(A) and contrast-enhanced (B) T1-weighted MR images and helical
CT scan (C) show concentric tumor with strong contrast enhancement in
gastric body. Extraluminal nodule of gastric tumor and infiltration in
adjacent fat (arrows, A and C) are well seen on
A and C. Note few enlarged lymph nodes in left perigastric
region (arrowheads, A and C). On B, demarcation
of gastric tumor and lymph nodes is blurred with motion artifact.
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Fig. 2A. —69-year-old man with stage T4 gastric cancer. Axial unenhanced
(A) and contrast-enhanced (B) T1-weighted MR images and helical
CT scan (C) show concentric tumor with little contrast enhancement in
gastric antrum. Small tumor infiltration in gallbladder wall
(arrowheads, A) is well seen on A but not on B
or C.
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Fig. 2B. —69-year-old man with stage T4 gastric cancer. Axial unenhanced
(A) and contrast-enhanced (B) T1-weighted MR images and helical
CT scan (C) show concentric tumor with little contrast enhancement in
gastric antrum. Small tumor infiltration in gallbladder wall
(arrowheads, A) is well seen on A but not on B
or C.
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Fig. 2C. —69-year-old man with stage T4 gastric cancer. Axial unenhanced
(A) and contrast-enhanced (B) T1-weighted MR images and helical
CT scan (C) show concentric tumor with little contrast enhancement in
gastric antrum. Small tumor infiltration in gallbladder wall
(arrowheads, A) is well seen on A but not on B
or C.
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Fig. 3A. —44-year-old man with stage T2 gastric cancer. Axial helical CT scan
shows focal wall thickening with strong contrast enhancement along lesser
curvature of gastric body (arrows). Because of low density beneath
enhancing tumor, which represents submucosal layer, cancer was incorrectly
diagnosed as stage T1 (CTT1).
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Fig. 3B. —44-year-old man with stage T2 gastric cancer. T1-weighted MR image
fails to show lesion.
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Fig. 3C. —44-year-old man with stage T2 gastric cancer. Photomicrograph of
surgical specimen shows adenocarcinoma cells infiltrating inner circular
muscle of muscularis propria (stage pT2) (arrows). (H and E,
x40)
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Fig. 4A. —37-year-old woman with stage T3 gastric cancer (pT3). Axial
unenhanced T1-weighted MR image shows change in signal intensity of pancreas
body with contiguous tumor extension from gastric body (arrows).
Change in signal intensity was incorrectly diagnosed as pancreatic invasion
(MRT4).
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Fig. 4B. —37-year-old woman with stage T3 gastric cancer (pT3). Consecutive
axial helical CT scans show no significant change in attenuation of pancreas
and relatively distinct fat plane between pancreas and gastric lesion (CTT3).
No pancreatic invasion was detected at surgery (pT3).
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Fig. 5A. —54-year-old woman with stage T4 gastric cancer. Axial helical CT
image shows pancreatic invasion by gastric tumor (CTT4) (arrows).
Note poor demarcation of lesion from adjacent bowel. Consecutive CT scans
revealed tumor extending from gastric antrum. P = head of pancreas.
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Fig. 5B. —54-year-old woman with stage T4 gastric cancer. Coronal T1-weighted
MR image shows matted appearance of gastric tumor, duodenal loop, and omentum
of hepatic flexure of colon (MRT4) (arrows). These structures adhered
to each other and were infiltrated by tumor, as noted at surgery (pT4). Star
indicates pyloric antrum of stomach.
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