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At least 649 records · Page 36Linked to original sources

PubMed2006

Pathological diagnosis of paediatric tumours from image-guided needle core biopsies: a systematic review.

BACKGROUND: Image-guided core needle biopsy is widely used in paediatric oncology, but many protocols continue to discourage this practice. No published randomized studies compare image-guided needle biopsy with surgical techniques. OBJECTIVE: To perform a systematic review of the literature on image-guided core needle biopsy in paediatric oncology. MATERIALS AND METHODS: Several computerized databases were searched using the terms [(needle OR core) AND (biops*[ti]) AND (paediatric OR pediatric OR child OR children OR childhood OR boy OR girl)[ti]] to identify series of more than five cases of needle core biopsy for tumour diagnosis in children. Data from included studies were combined to calculate pooled estimates of adequacy, accuracy and complication rates. RESULTS: Thirteen studies fulfilled the inclusion criteria. Overall biopsy adequacy rate (defined as sufficient to make a diagnosis) was 94% (95% CI 92-96%). The diagnostic accuracy rate in cases with adequate material (defined as achieving the correct specific diagnosis) was 94% (95% CI 92-96%). Complications requiring treatment occurred in 1%. CONCLUSIONS: Available pooled data suggest that about 95% of image-guided needle core biopsies provide an adequate sample for diagnosis of malignant disease in childhood. In such cases, the pathological diagnosis is correct in about 95%. Complications are rare.

Biopsy, Needle↗

PubMed1999

Effect of whole-body vibration on the low back. A study of tractor-driving farmers in north India.

STUDY DESIGN: A retrospective cohort study of tractor-driving farmers (study group) and non-tractor-driving farmers (control group) matched for age, gender, generic/ethnic group, land-holding, and work routines. OBJECTIVES: To determine, using magnetic resonance imaging and clinical investigations, the effect of whole-body vibrations on the back in tractor-driving farmers. SUMMARY OF BACKGROUND DATA: Low back pain and pathologic changes in the lower backs of tractor drivers have been reported. However, no study with a control group matched for work-related risk factors has been reported. METHODS: Fifty tractor-driving farmers were compared with 50 non-tractor-driving farmers matched for age, gender, ethnic group, land-holding, and work routine. Both groups were interviewed for details of work routine, assets held, family profile, and vibration exposure to assess the influence of these parameters on signs and symptoms of backache. Magnetic resonance imaging was done to assess the effect of exposure on whole-body vibration and degenerative changes in the back. Vibration measurements also were done on tractors to observe the actual severity of the vibrations. RESULTS: Regular work-related backache was more common among tractor-driving farmers (40%) than among non-tractor-driving farmers (18%, P = 0.015). Anthropometric evaluation showed abdominal girth and weight to be significantly higher in tractor-driving farmers (P = 0.006 and 0.046, respectively), whereas while height and arm span were similar between the two groups. Clinical examination for evidence of disc or facet degeneration showed no difference between the two groups. Evaluation of magnetic resonance images of tractor-driving farmers and non-tractor-driving farmers by an orthopedic surgeon, radiologist, and neurosurgeon showed degenerative changes to be similar between the two groups (P > 0.050). CONCLUSIONS: Tractor-driving farmers report backache more often than non-tractor-driving farmers, but no significant objective differences on clinical or magnetic resonance imaging evaluation were found between the two groups.

Adult↗

PubMed1984

Evaluation of renal masses by MR imaging.

Magnetic resonance (MR) imaging was performed in 20 subjects, 10 of whom had benign or malignant renal masses, and 10 were normal volunteers. The purpose of the study was to evaluate the ability of MR to provide significant diagnostic information in the management of renal mass lesions. Ten normal patients were included to supply baseline data. Different pulse sequences were used and their contribution to the diagnosis was evaluated. The emphasis has been placed on evaluating MR against the pathological diagnosis rather than other imaging modalities.

Adenocarcinoma↗

PubMed1986

Dynamic isotopic phlebography using soluble krypton-81m.

Intravenous peripheral injection of krypton-81m in an isotonic solution permits venous scintigraphy of the lower limbs to be carried out. An anatomic definition of the obstructions and the collateral pathways is therefore easily displayed from the popliteal vein to the vena cava. The physical characteristics of the radionuclide permit iterative or sustained perfusions without accumulation of an excessive background noise and the method is used to obtain scintigraphic images in changing physiological conditions. Analysis of the dynamic data permits venous stasis to be assessed in terms of regional radioactivity at a steady state and transit rate. Various physiological and pathological conditions are analyzed by this method.

Hemodynamics↗

PubMed2001

Simulation and analysis of magnetic resonance elastography wave images using coupled harmonic oscillators and Gaussian local frequency estimation.

New methods for simulating and analyzing Magnetic Resonance Elastography (MRE) images are introduced. To simulate a two-dimensional shear wave pattern, the wave equation is solved for a field of coupled harmonic oscillators with spatially varying coupling and damping coefficients in the presence of an external force. The spatial distribution of the coupling and the damping constants are derived from an MR image of the investigated object. To validate the simulation as well as to derive the elasticity modules from experimental MRE images, the wave patterns are analyzed using a Local Frequency Estimation (LFE) algorithm based on Gauss filter functions with variable bandwidths. The algorithms are tested using an Agar gel phantom with spatially varying elasticity constants. Simulated wave patterns and LFE results show a high agreement with experimental data. Furthermore, brain images with estimated elasticities for gray and white matter as well as for exemplary tumor tissue are used to simulate experimental MRE data. The calculations show that already small distributions of pathologically changed brain tissue should be detectable by MRE even within the limit of relatively low shear wave excitation frequency around 0.2 kHz.

Algorithms↗

PubMed2004

Power Doppler vascularity index for predicting the response of neoadjuvant chemotherapy in cervical carcinoma.

BACKGROUND: To evaluate whether the power Doppler vascularity index (PDVI) can predict the response to neoadjuvant chemotherapy (NACT) in cervical carcinoma. METHODS: Twenty-five women with bulky early stage cervical carcinoma treated by NACT followed by surgery were enrolled. Their response to NACT was evaluated. Clinical characteristics and pathologic data were recorded. Transvaginal power Doppler was performed before, during and after NACT. PDVI was detected using power Doppler and a quantitative image processing system. Factors that can potentially correlate with the response to NACT were analyzed. RESULTS: Twelve (48%) patients showed a response (responders) to NACT and 13 (52%) were unchanged or had progressive disease (nonresponders) after NACT. Higher PDVI values were noted in tumors with lymphovascular emboli and pelvic lymph node metastasis both before and after NACT. The mean values of the PDVI of the nonresponders before (19.27 +/- 6.01 vs. 12.28 +/- 7.06, p = 0.014), during (20.2 +/- 1.5 vs. 12.9 +/- 2.1, p = 0.009) and after NACT (18.1 +/- 6.0 vs. 9.3 +/- 5.4, p = 0.001) were significantly higher than those of the responders. When the cutoff point for predicting nonresponders to NACT was set at a PDVI value of 15%, the sensitivity was 92.3% and the specificity 66.7%. CONCLUSIONS: The power Doppler vascularity index can predict the response to neoadjuvant chemotherapy in cervical cancer, and might be useful for the evaluation of response to chemotherapy in cancer patients in the future.

Adenocarcinoma↗

PubMed1996

Morphometric analysis of the lumbosacral nerve roots and dorsal root ganglia by magnetic resonance imaging.

STUDY DESIGN: Lumbosacral nerve roots and dorsal root ganglia in relation to surrounding bony structures in normal subjects were investigated using magnetic resonance imaging. OBJECTIVES: This study determined the normal anatomic parameters of the lumbosacral nerve root and dorsal root ganglion, to which degenerative or pathologic changes may be compared. SUMMARY OF BACKGROUND DATA: In the previous literature, most authors have used various modalities in either cadavers or symptomatic patients to study the anatomic details of the lumbar nerve roots and dorsal root ganglia. The data in the literature are conflicting, mainly because of individual variations and different degrees of degenerative change in the spine. METHODS: Twenty male volunteers who had no back pain or radiculopathy underwent magnetic resonance imaging. Ages ranged from 22 to 38 years, with a mean of 30.4 years. T1-weighted coronal magnetic resonance images were taken from L1 to S1. Two hundred thirty-three nerve roots were examined, including 36 L1, 40 L2, 40 L3, 39 L4, 40 L5, and 38 S1. nerve roots Measurements were determined using a computer digitizer. RESULTS: The nerve root origin was at a more cephalad level for the caudad nerve roots, particularly the S1. The take-off angels acutely changed at L1 and S1. The length of the nerve roots increased progressively to a maximum at L5, and decreased at S1. The center of the dorsal root ganglion was positioned more cephalad at S1. The average dimension of the dorsal root ganglion gradually increased from L1 to S1. The most striking difference was in the S1 root, which takes off more cephalad, at a more vertical angle, and has the shortest length of any of the nerve roots. The S1 dorsal root ganglion was also unique in that it was the largest and more frequently located intraspinally. CONCLUSION: The anatomy of the lumbar nerve roots and dorsal root ganglia and their relations to bony structures have been better defined in this study. Because of its more medial location, S1 radiculopathy may involve both the nerve root and dorsal root ganglion as a result of either disc herniation or degenerative L5-S1 facet changes. The relatively larger dorsal root ganglia and the greater dorsal root ganglion/foramen height ratios in the lower lumbar region may explain the higher incidence of L5 or S1 radiculopathy, particularly given the propensity to disc degeneration and intervertebral foraminal narrowing in the lower lumbar region.

Adult↗

PubMed1995

1995 AUR Memorial Award. Gamma knife irradiation-induced changes in the normal rat brain studied with 1H magnetic resonance spectroscopy and imaging.

RATIONALE AND OBJECTIVES: The pathogenesis of brain injury following radiosurgery is poorly understood. To better elucidate the relationship between blood-brain barrier disruption and metabolic derangements, we used magnetic resonance (MR) imaging and 1H MR spectroscopy to detect early changes from focused single-fraction, high-dose irradiation injury in rat brains. METHODS: Using the Leksell gamma knife, we irradiated the frontoparietal cortex of 11 male Wistar rats with a single dose of 120 Gy. Four weeks later, we sequentially performed water-suppressed 1H MR spectroscopy and gadopentetate dimeglumine-enhanced T1-weighted MR imaging. Metabolic maps were created of n-acetylaspartate (NAA), creatine and choline (Cr/Cho), and lactate from the MR spectroscopy data set. Detection of irradiation injury among the tested modalities was assessed by receiver operating characteristic analysis and by quantitative signal intensity changes. Pathologic confirmation of irradiation damage was obtained in all rats. RESULTS: Gadopentetate dimeglumine-enhanced T1-weighted MR imaging was the only imaging modality that detected statistically significant signal intensity changes (p < .05). No reproducible changes in the metabolites of interest could be detected by 1H MR spectroscopy. CONCLUSION: In our animal model, blood-brain barrier disruption was a reproducible, integral finding of single-fraction, high-dose irradiation injury. No reproducible metabolic derangements of ischemia or necrosis were detected by 1H MR spectroscopy, possibly because of dose-latency effects or sensitivity issues.

Animals↗

PubMed1993

Alterations in regional cerebral blood flow, with increased temporal interhemispheric asymmetries, in the normal elderly: an HMPAO SPECT study.

Single photon emission computed tomography (SPECT) with the tracer 99Tcm-hexamethylpropyleneamine oxime (HMPAO) provides images allowing semiquantitative estimation of regional cerebral blood flow (rCBF). Despite its widespread use there is little data on patterns of rCBF obtained using this tracer in normal elderly subjects, although other methods of measurement suggest a fall in cerebral blood flow with age. Furthermore, the detection of interhemispheric asymmetries on HMPAO SPECT is often used to identify areas of pathological abnormality yet there is little data on the prevalence of asymmetries in the normal elderly. An increased prevalence of asymmetries in the elderly may explain the difficulties recently reported in using functional imaging in the diagnosis of Alzheimer's dementia. Patterns of HMPAO uptake were compared in 10 young (mean age 24.9 years; range 21-34 years) and 10 elderly (mean age 74.1 years; range 70-76 years) normal subjects. Percentage interhemispheric asymmetry ratios were calculated and found to be greater in the elderly, particularly for the temporal cortex (young 0.87%, elderly 3.73%, P < 0.001). The proportion of injected HMPAO taken up by the head was 29% higher in the younger age group. Analysis of regional uptake revealed that this trend towards reduced uptake in the elderly was a global phenomenon affecting all brain regions. The increased interhemispheric asymmetries seen in the elderly imply that a higher threshold for interpreting asymmetries as abnormal must be used in the elderly, particularly for the temporal cortex.

Adult↗

PubMed2007

High-field magnetic resonance imaging of meniscoids in the zygapophyseal joints of the human cervical spine.

STUDY DESIGN: Prospective in vitro study of meniscoids in the cervical zygapophysial joints. OBJECTIVES.: To assess the use of high-field magnetic resonance imaging (MRI) as a potential tool for evaluating meniscoids of the cervical zygapophysial joints. SUMMARY OF BACKGROUND DATA: Pain originating from the cervical spine is a frequent condition. It has been suggested that pathologic conditions of meniscoids within the zygapophysial joints may cause pain. METHODS: Six zygapophysial joints from one embalmed human body were investigated with a 3.0-T MR unit, equipped with a microimaging-set. MRIs were correlated with microanatomical sections. RESULTS: High-quality images of the meniscoids were obtained for all joints examined. There was a good correlation between the anatomic features derived from MRI and the microanatomical sections. CONCLUSIONS: High-field MRI was successfully implemented as a noninvasive method for imaging the meniscoids in cervical zygapophysial joints. The results of this in vitro study indicate that high-field MRI may be feasible in evaluating patients with cervical pain possibly related to meniscoid pathology.

Anatomy, Cross-Sectional↗

PubMedDate not supplied

High b-value q-space analyzed diffusion-weighted MRS and MRI in neuronal tissues - a technical review.

This review deals with high b-value q-space diffusion-weighted MRI (DW-MRI) of neuronal tissues. It is well documented that at sufficiently high b-values (and high q-values) neuronal water signal decay in diffusion experiments is not mono-exponential. This implies the existence of more than one apparent diffusing component or evidence for restriction. The assignment of the different apparent diffusing components to real physical entities is not straightforward. However, the apparent slow diffusing component that was found to be restricted to a compartment of a few microns, if originating mainly from a specific pool and if assigned correctly, may potentially be used to obtain more specific MR images with regard to specific pathologies of the CNS. This review examines the utility of analyzing high b-value diffusion MRS and MRI data using the q-space approach introduced by Callaghan and by Cory and Garroway. This approach provides displacement probability maps that emphasize, at long diffusion times, the characteristics of the apparent slow diffusing component. Examples from excised spinal cord, where the experimental conditions for which the q-space analysis of MR diffusion data was developed can be met or approached will be presented. Then examples from human MS patients, where q-space requirement for the short gradient pulse is clearly violated, are presented. In the excised spinal cord studies, this approach was used to study spinal cord maturation and trauma, and was found to be more sensitive than other conventional methods in following spinal cord degeneration in an experimental model of vascular dementia (VaD). High b-value q-space DWI was also recently used to study healthy and MS diseased human brains. This approach was found to be very sensitive to the disease load in MS, compared with other conventional MRI methods, especially in the normal appearing white matter (NAWM) of MS brains. Finally, the potential diagnostic capacity embedded in high b-value q-space analyzed diffusion MR images is discussed. The potentials and caveats of this approach are outlined and experimental data are presented that show the effect of violating the short gradient pulse (SGP) approximation on the extracted parameters from the q-space analysis.

Algorithms↗

PubMed2002

MR imaging-guided radio-frequency thermal ablation of the lumbar vertebrae in porcine models.

PURPOSE: To test the hypotheses that (a) magnetic resonance (MR) imaging-guided radio-frequency (RF) thermal ablation of the vertebrae is feasible in porcine models, (b) procedure safety depends on the location of ablation within the vertebra, and (c) MR imaging allows accurate monitoring of induced thermal lesion size and shape. MATERIALS AND METHODS: Ten percutaneous MR imaging-guided RF thermal ablations were randomized over various lumbar vertebral levels and locations in seven pigs. Animals were followed up for 2, 7, or 14 days before sacrifice. Thermal lesion size and shape as measured on MR images obtained immediately after ablation and at follow-up were compared with gross pathologic findings. Mean absolute differences between lesion diameters at pathologic examination and MR imaging were evaluated by using a paired t test, as were differences between lesion-to-vertebra contrast-to-noise ratios obtained for each sequence. Clinical and imaging data were correlated with histologic findings. RESULTS: Successful RF electrode placement in the targeted part of the vertebra was achieved in all procedures. Ablations performed away from neural elements were safe to perform. Pedicular ablations resulted in radiculopathy, whereas ablations performed directly over the posterior cortex resulted in paraplegia. Lesion sizes measured on T2-weighted images were closest to those measured at gross pathologic examination (mean absolute difference, 0.72 mm +/- 0.83 [SD]), followed by those measured on contrast material-enhanced T1-weighted (1.27 mm +/- 0.83) and short inversion time inversion-recovery (STIR) (1.5 mm +/- 1.84) images. Size measurements obtained on T2-weighted images were significantly closer to gross pathologic measurements than were those obtained on contrast-enhanced T1-weighted images (P =.013) but were not different from those obtained on STIR (P =.27) images. The contrast-to-noise ratio was significantly higher for contrast-enhanced T1-weighted images than for T2-weighted (P <.001) or STIR (P <.001) images. CONCLUSION: MR imaging-guided RF thermal ablation of the vertebrae is feasible in porcine models, but the safety of the procedure depends on the location of ablation within the vertebra. MR imaging allows accurate monitoring of thermal lesion size and shape.

Animals↗

PubMedDate not supplied

Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers.

The purpose of this study was to evaluate the magnetic resonance imaging findings in both shoulders of asymptomatic professional baseball pitchers. Fourteen pitchers who were without significant prior injury underwent a blinded clinical assessment and magnetic resonance imaging of both shoulders. All images were interpreted by two experienced musculoskeletal radiologists. The appearance of the rotator cuff tendons was graded, with additional evaluation of the biceps, labrum, and osseous structures. Ten athletes were found to have stable shoulders and painless full range of motion. Clinically, four athletes had at least a 40 degrees loss in internal rotation as compared with the nonthrowing arm. There were no significant differences in magnetic resonance imaging findings of the supraspinatus and infraspinatus tendons between the throwing and nonthrowing shoulders. The labrum was abnormal in 79% of the 28 shoulders. Enthesopathic changes of the posterior glenoid labrum were identified in the four pitchers who had loss of internal rotation. We conclude that unenhanced magnetic resonance imaging of the shoulder in asymptomatic high performance throwing athletes reveals abnormalities that may encompass a spectrum of "nonclinical" findings. These data can be useful in separating symptomatic pathologic findings from these variants. Enthesopathic changes of the posterior glenoid labrum in the throwing arm may represent an early Bennett-type lesion. The cause may be excessive traction on the posterior capsule during the pitching motion, with subclinical injury to this area.

Acromion↗

PubMed2006

A pathological approach to anomalies of the posterior fossa.

BACKGROUND: Both clinical and postmortem diagnoses of posterior fossa anomalies remain difficult to make and to corroborate. This is particularly true for Dandy-Walker malformation and variant. Difficulties arise for a variety of reasons, including technical and methodological ones, but also because the conditions may overlap anatomically with others, most notably mega cisterna magna, Blake's pouch cyst, and posterior fossa (arachnoid) cysts. Family counseling is difficult and complicated not only by diagnostic uncertainties but by the highly variable prognosis. METHODS: In this study, a systematic pathologic approach to study of the posterior fossa is put forth. The benefits of postmortem imaging and in situ and ex situ examination of posterior fossa contents are demonstrated. RESULTS: Normative data for cerebellar width (transverse cerebellar diameter) and height and vermian width and height are derived for the fetal period. These data will help workers recognize changes in these structures, particularly hypoplasia. CONCLUSIONS: Basic morphologic definitions of posterior fossa anomalies are advanced, in the hopes that better agreement can be reached between clinical and pathologic diagnoses and that better patient and family care will result.

Age Factors↗

PubMed1997

Compression guidelines for diagnostic telepathology.

As the healthcare community has begun to rely increasingly upon digital technologies for acquisition, storage, and transmission of pictorial data, image compression has become an indispensable tool. We have investigated the feasibility of lossy compression in a well-defined task domain, the clinical assessment of digitized images of chromatic microscopic pathology specimens. The effect of compression was measured under two distinct perceptual criteria, just noticeable difference (j.n.d.) and largest tolerable distortion (l.t.d.), differing in the involvement required from subjects, who were experts in pathology. For standard JPEG compressed images it was found that when the experiment is performed under the l.t.d. criterion, a significantly larger compression ratio is reported as satisfactory. It is concluded that lossy compression holds promise for diagnostic telepathology.

Algorithms↗

PubMed1998

The value of stereolithographic models for preoperative diagnosis of craniofacial deformities and planning of surgical corrections.

The purpose of this study was to assess the importance of stereolithographic models (SLMs) for preoperative diagnosis and planning in craniofacial surgery and to examine whether these models offer valuable additional information as compared to normal CT scans and 3D CT images. Craniofacial SLMs of 20 patients with craniomaxillofacial pathology were made. A helical volume CT scan of the anatomic area involved delivered the necessary data for their construction. These were built with an SLA 250 stereolithography apparatus (3D-Systems, Valencia, CA, USA), steered by FORM-IT/DCS software (University of Zurich, Switzerland). The stereolithography models were classified according to pathology, type of surgery and their relevance for surgical planning. Though not objectively measurable, it was beyond doubt that relevant additional information for the surgeon was obtained in cases of hypertelorism, severe asymmetries of the neuro- and viscerocranium, complex cranial synostoses and large skull defects. The value of these models as realistic "duplicates" of complex or rare dysmorphic craniofacial pathology for the purpose of creating a didactic collection should also be emphasized. The models proved to be less useful in cases of consolidated fractures of the periorbital and naso-ethmoidal complex, except where there was major dislocation.

Adolescent↗

PubMed1988

Magnetic resonance imaging and computerized tomography in central hypoventilation.

Central hypoventilation syndrome (CHS) is a disorder of respiratory control. It may be an idiopathic primary disease or it may be the secondary consequence of an infectious process or Chiari II malformation. Clinical data suggest that the primary defect involves the brainstem respiratory centers. To date, pathologic evaluation has linked primary CHS with decreased density of neurons and myelinated nerve fibers in the medulla and brainstem gliosis, and absence of the external arcuate nucleus. Magnetic resonance imaging (MRI) is now considered the most reliable imaging technique for evaluating the brainstem. In the hope of finding gross structural abnormalities that might correlate with the clinical and pathologic features of CHS, we used MRI and computerized tomography (CT) to evaluate the brain, brainstem, and spinal cord of 17 infants and children with central hypoventilation (11 primary, 6 secondary). Each of the 11 children with primary CHS demonstrated a normal brainstem and spinal cord by MRI. However, 9 of 11 infants had mild ventricular dilatation and modest prominence of the sulci interpreted as either mild atrophy or mild extraventricular obstructive hydrocephalus. Results of studies in the one child with postinfectious disease were normal. The 5 infants with Chiari II malformation demonstrated characteristic brainstem changes. MRI results modified clinical care, resulting in symptomatic improvement after hindbrain decompression by cervical laminectomy in 1 infant and surgical drainage of syringobulbia in 1 child. In summary, in primary CHS, the MRI and CT provided evidence for a more diffuse CNS process rather than a specific brainstem lesion. Such a lesion may be too small or too subtle to resolve with MRI or CT. In secondary central hypoventilation, MRI modified surgical management in 2 cases, resulting in symptomatic improvement of hypoventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Arnold-Chiari Malformation↗

PubMedDate not supplied

Advanced gastric carcinoma: the role of three-dimensional and axial imaging by spiral CT.

BACKGROUND: The purpose of this study was to assess the role of three-dimensional (3D) and axial imaging by spiral computed tomography (CT) in the evaluation of advanced gastric carcinoma (AGC). METHODS: Sixty patients with AGC underwent 3D and axial imaging by spiral CT. Among them, 40 cases were confirmed by surgery. The remaining 20 cases showed typical findings of AGC with upper gastrointestinal series and gastroscopy that were proved by endoscopic biopsy. Spiral CT was performed with 3-mm collimation, 4. 5-mm/s table feed, and 1.5-mm reconstruction interval in the supine position after ingestion of gas. Three-dimensional images using the shaded surface display (SSD) technique were analyzed and graded (excellent, good, or poor). A second dual-phase spiral CT scan was performed with 5-mm collimation, 7-mm/s table feed, and 5-mm reconstruction interval in the prone position after ingestion of water. RESULTS: Among 60 cases of AGC, there were two cases (3.4%) of Borrmann type 1, 12 cases (20.0%) of Borrmann type 2, 32 cases (53.3%) of Borrmann type 3, 11 cases (18.3%) of Borrmann type 4, and three cases (5.0%) of Borrmann type 5. Of the 60 cases of AGC, excellent 3D images were obtained in nine patients (15.0%), good 3D images in 39 (65.0%), and poor 3D images in 12 (20.0%). Among the 12 patients with poor images, cancers were located at the pyloric antrum in eight cases (66.7%), were AGC Borrmann type 4 in three cases (25.0%), and early gastric carcinoma (EGC)-mimicking lesion (AGC Borrmann type 5) in one case (8.3%). Cancers involving the antrum tended to show poor images (p < 0.05). Using axial images, Borrmann's classification based on tumor morphology was accurately identified in 41 cases (68.3%); however, using 3D imaging, 52 cases (86.7%) were accurately classified (p < 0.05). In 40 cases receiving surgery, good correlation between axial CT image and pathology occurred in 70.0% of T class and 72.5% of N class. CONCLUSIONS: Three-dimensional images of AGC by spiral CT data were good or excellent in 80%, and combining 3D images with axial CT imaging improved the accuracy in classifying Borrmann type and tumor staging.

Adenocarcinoma↗