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Early Gastric Carcinoma: Evaluation with High-Spatial-Resolution MR Imaging in Vitro¹

¹ From the Departments of Radiology (I.Y., H.S.), Surgery (N.S., K.T.), and Pathology (J.K.), Faculty of Medicine, and the Department of Dental Radiology Faculty of Dentistry, (N.Y., A.T.), Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Received August 19, 2000; revision requested September 26; revision received November 16; accepted January 8, 2001. Address correspondence to I.Y. (e-mail: yamada.crad@med.tmd.ac.jp).

PURPOSE: To determine signal intensity characteristics of the gastric wall layers and to assess the accuracy of the evaluation of early gastric carcinomas in vitro by using resected specimens studied with high-spatial-resolution magnetic resonance (MR) imaging.

MATERIALS AND METHODS: Fifteen gastric specimens obtained from patients suspected of having early gastric carcinoma were studied with a 1.5-T MR system with a 4-cm-diameter loop coil. High-spatial-resolution spin-echo MR images were obtained with a field of view of 50 mm, a matrix of 256 x 256, and a section thickness of 2 mm, resulting in a voxel size of 0.08 mm³. Findings from MR images were compared with histopathologic findings.

RESULTS: T1- and T2-weighted MR images clearly depicted the normal gastric wall as consisting of four and six layers, respectively, which corresponded well to the histologic layers. In 14 (93%) of 15 gastric carcinomas, the depth of mural invasion visualized with MR imaging correlated well with the histopathologic stage. The stage determined with MR imaging, however, was lower in one instance (7%) than the histopathologic stage. MR imaging also depicted the gross features of the tumor, presence of ulceration, and adjacent lymph node swelling.

CONCLUSION: High-spatial-resolution MR imaging has a high diagnostic accuracy in the evaluation of the mural invasion of early gastric carcinoma in vitro and thus potentially enables preoperative histopathologic staging.

Index terms: Magnetic resonance (MR), tissue characterization, 72.121411, 72.32 • Specimens, MR, 72.32 • Stomach, MR, 72.121411 • Stomach, neoplasms, 72.32

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