Spiral CT of the gastric carcinoma: Staging and enhancement pattern

The purpose of this study was to correlate the preoperative staging of gast ric carcinoma using spiral computed tomography (CT) with pathologic staging and to correlate the enhancement pattern of advanced gastric carcinoma (AG C) on spiral CT with histological type. A total of 180 patients with gastri c carcinomas confirmed at surgery underwent spiral CT. After surgery, patho logic findings were compared with CT findings. The detection rate for T1 tu mors was 81.4% (57/70), and all T2-4 tumors were detected (110/110). In the T class, good correlation with pathology occurred in 47.8%. In the N class , good correlation with pathology occurred in 52.2%. The rate of understagi ng in the N class (31.7%) was higher than that of overstaging (16.1%) (P < .001). In AGC, the tumor mass showed delayed enhancement, regardless pf Bor rmann's type. By histological pattern, good and delayed enhancement was see n in 2/3 (66.7%) with signet ring cell type, but 4/5 (80%) with mucinous ty pe were poorly enhanced (P=.019). Spiral CT for determining the preoperativ e staging of gastric carcinoma was not accurate. However, the enhancement p attern of AGC correlated with histological type. (C) 2001 Elsevier Science Inc. All rights reserved.