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Differentiation of advanced gastric carcinoma with signet ring cell carcinoma and non-signet ring cell carcinoma using multidetector CT

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dc.descriptionDept. of Medicine/석사-
dc.description.abstract[한글] 인환세포형 위암은 전통적으로 종양세포의 세포질내에 다량의 점액과립이 함유되어 핵의 편위를 일으키는 특징이 있다. 비록 인환세포형 위암의 예후에 대한 결과가 일정하지는 않지만, 인환세포형 위암은 나쁜 예후 인자로 알려져 있다. 본 연구의 목적은 인환세포형 위암과 비인환세포형 위암간의 감별에 있어서, 두꺼워진 위벽을 중심으로 하여 다절편 전산화단층촬영(MDCT)의 유용성에 대하여 알아보조자 함이다. 병리조직학적으로 인환세포형 위암과 비인환세포형 위암으로진단받은 80명의 환자에 대하여, 두꺼워진 위벽의 육안적 모양, 주로 두꺼워진 층, 조영증강 양상, 조영증강 정도에 관하여 MDCT 영상을 후향적으로 분석하였고, 병리조직학적 소견과 비교하였다. 가장 흔한 위벽의 육안적 모양은 양쪽 위암 모두 균상이었고, 가장 흔한 조영증강 양상은 비계층적이었다. 가장 흔한 두꺼워진 층은 양쪽 위암 모두에서 내측이었다. 인환세포형 위암에서 비인환세포형 위암에 비하여, 고도의 조영증강을 보였으며, 병리조직학적으로는 인환세포형 위암세포와 성긴 섬유화조직이 조영증강이 잘 되는데 비하여, 조밀한 섬유화는 조영증강이 잘 되지 않았다. MDCT 영상소견으로 인환세포형 위암과 비인환세포형 위암의 감별은 어렵다. 하지만 인환세포형 위암에서 비인환세포형 위암에 비하여 고도의 조영증강이 보다 많은 빈도로 관찰되었다. [영문]Gastric cancer with signet ring cell histology has been classically characterized by cells containing a sufficient intracytoplasmic volume of mucin to compress the nucleus against the periphery of the cell. Although studies of the prognosis of gastric SRC are not consistent, SRC has been considered to be a poor prognostic factor. The purpose of our study was to assess the capability of MDCT to assist in the differentiation between gastric cancer with SRC and that with NSRC, with a focus on the thickened stomach wall itself. We retrospectively reviewed MDCT results in 80 patients with pathologically proven AGC with SRC(n=35) and NSRC(n=45). MDCT images of 80 patients were analyzed retrospectively on gross appearance of thickened gastric wall(polypoid/ fungating/ ulcerative/ diffuse infiltrative), predominantly thickened layer(inner/outer), contrast-enhancement pattern(non-layered/ layered) and degree of enhancement(high/moderate/low). And we correlated the CT findings with the histopathologic findings by means of a layer-to-layer comparison. The most common type of gross appearance in both carcinomas was fungating and the more common contrast enhancement pattern in both carcinomas was a non-layered pattern. The predominantly thickened layer was a high attenuation inner layer in both carcinomas. High degree contrast-enhancement was more common in AGC with SRC(37.1% of patients) than AGC with NSRC(15.6% of patients). In SRC with histopathological review, the groups of malignant cells and immature fibrosis enhance well whereas mature fibrosis shows poor enhancement. It was difficult to distinguish AGC with SRC from that with NSRC based on the MDCT findings of the thickened stomach wall alone. But, high degree contrast enhancement was more common in AGC with SRC than AGC with NSRC.-
dc.publisherGraduate School, Yonsei University-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleDifferentiation of advanced gastric carcinoma with signet ring cell carcinoma and non-signet ring cell carcinoma using multidetector CT-
dc.title.alternative진행성 위암에서 인환세포형과 비인환세포형간의 감별을 위한 다절-
dc.contributor.alternativeNameLee, Jei Hee-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 2. Thesis


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