Stomach diseases: MR evaluation using combined T2-weighted single-shot echo train spin-echo and gadolinium-enhanced spoiled gradient-echo sequences

The aim of this study was to describe the magnetic resonance (MR) appearanc es of diseases of the stomach using combined T1-weighted spoiled gradient-e cho, T2-weighted single-shot echo train spin-echo and gadolinium-enhanced s poiled gradient-echo sequences. All patients with gastric diseases who unde rwent combined T2-weighted single-shot echo train spin-echo and gadolinium- enhanced conventional and fat-suppressed spelled gradient-echo Imaging betw een October 1, 1996 and March 1, 1999, and who had histological or other im aging proof of disease, were Included in this study, This patient populatio n was comprised of 40 patients with subsequently proven gastric abnormaliti es, Including malignant tumors (25) or benign disease (15), The MRI sequenc es included T1-weighted, T2-weighted, and early and late gadolinium-enhance d spoiled gradient-echo (SGE) images. Evaluation was made of the following parameters: a) the ability to detect the disease process on MRI, by compari ng the original prospective MR reports with the records of the pathology de partment; b) the MR appearance of a variety of gastric diseases; and c) the sequences that most clearly demonstrated abnormalities by retrospective re view of the MR studies. MR images demonstrated 22 of 25 malignant tumors, E valuation of the extent of the tumor was correctly shown in 22 of 25 tumors . Small-volume tumor tone patient with gastric adenocarcinoma. and one pati ent with lymphoma) and coexistent infiltrative adenocarcinoma and gastritis (one patient) rendered demonstration of tumor poor on MR images in three p atients. Tumors were mildly hypointense on T1-weighted images and mildly hy perintense on T2-weighted images. Tumors enhanced in a heterogeneous fashio n compared with background stomach wall, but they ranged from hypointense t o hyperintense on early and late post-gadoliniun SGE images. Regarding beni gn diseases, the changes of gastritis were evident in three of four cases. Gastritis appeared as increased mucosal enhancement that ranged from modera te to intense on early and late post-gadolinium SGE images. Imaging finding s of the various entitles are described in greater detail in the text. MR f indings in a variety of neoplastic and non-neoplastic diseases of the stoma ch are described, Neoplastic diseases were consistently observed in most ca ses; however small tumors and tumors coexistent with inflammatory changes w ere poorly evaluated, The changes of gastritis were demonstrated as Increas ed enhancement of the gastric wall. (C) 1999 Wiley-Liss, Inc.