CT evaluation of gastric cancer: depth of tumor invasion and pancreas invasion.

PURPOSE: To compare the internal structure of tumor and the contiguous organ configuration on computed tomography (CT) with the depth of tumor invasion on the pathological specimen. METHODS: Sixty-four gastric cancers depicted on incremental dynamic CT were classified according to the internal structure of the tumor, and correlated with the depth of tumor invasion. In addition, the cancers were classified according to the contiguous pancreatic configuration, and correlated with the degree of pancreatic invasion. RESULTS: Eleven tumors with thickened gastric wall consisting of both a thick inner layer of high attenuation and a thin outer layer of low attenuation (two-layered tumor with a thin outer layer) did not invade the serosa: mucosa (n = 5) and submucosa (n = 6). Of 59 gastric cancers with a regular margin to the contiguous pancreas, pancreatic invasion was absent in 58 and present in one. Pancreatic invasion was present in all of five gastric cancers with an irregular margin. CONCLUSIONS: Our results indicate that two-layered gastric tumors with a thin outer layer never invade the serosa. Furthermore, pancreatic invasion is predicted only when the margin of the contiguous pancreas is irregular.

[Scirrhous gastric carcinoma: utility of computed tomographic diagnosis].

Fifty gastric carcinoma lesions were classified into three groups depending on their morphologic characteristics on incremental dynamic computed tomography (CT). Two-layered tumors (23 cases) showed both an outer layer of low attenuation and a thick inner layer of high attenuation. Furthermore, they were classified into two subgroups depending on the thickness of the outer layer. Two-layered tumors showing a thick outer layer (13 cases) were all scirrhous carcinomas. The mean thickness was 11.05 +/- 3.38 mm for the outer layer, and 4.40 +/- 1.92 mm for the inner layer. The thick outer layer corresponded histopathologically to the layer submucosal to the serosa, and the thick inner layer, to the mucosal layer. Two-layered tumors showing the thin outer layer (10 cases) were all non-scirrhous carcinomas. The mean thickness was 1.62 +/- 0.47 mm for the outer layer, and 12.34 +/- 8.68 mm for the inner layer. Tumors of high attenuation (12 cases) and tumors of low attenuation (15 cases) were also nonscirrhous carcinomas. In conclusion, all scirrhous carcinomas showed both a thick outer layer and a thick inner layer, whereas non-scirrhous carcinomas did not have appearance. This new classification can serve as a guideline for predicting scirrhous carcinoma on the basis of CT findings.

Bone mineral density of the lumbar spine by dual photon absorptiometry: age-related regression in normal Japanese subjects and fracture threshold in osteoporotics.

The bone mineral density (BMD) of the lumbar spine was determined by DPA in 280 normal Japanese volunteers and 11 osteoporotic women with compression fractures. In women, bone loss started from the mid thirties and accelerated after the age of 50 years at the rate of 0.75% (0.0074 g/cm2) per year. In men, bone loss started from the mid twenties and occurred linearly at the rate of 0.30% (0.0032 g/cm2). The overall diminutions in vertebral BMD throughout life in men and women were 13.0% and 24.3%, respectively. The mean vertebral BMD of the osteoporotic women with recent compression fractures was 37.5% lower than that of age-matched controls. The 90th percentile for vertebral BMD in this group was 0.584 g/cm2. By the age of 80 years, approximately one-fifth of normal Japanese women have BMD values less than this.

Pancrease divisum: CT and ERCP findings.

A case of pancreas divisum diagnosed by CT is reported. ERCP via the major pipilla revealed a very short pancreatic duct, which appeared to be abruptly interrupted by a tumor. CT, however, demonstrated two definite pancreatic moieties separated by a fat cleft, indicating the presence of pancreas divisum.