| Objective: To evaluate the value of multislice spiral CT in distinguishing gastric mucinous adenocarcinoma from signet ring cell carcinoma and other non-mucinous adenocarcinoma.Methods: All gastric cancer cases confirmed by surgery in Affiliated Cancer Hospital of Xinjiang Medical University from January 2019 to December 2021 with complete data were collected.A total of 103 cases of gastric cancer were selected who underwent preoperative multislice spiral CT scan plus enhanced examination,including 31 cases of mucinous adenocarcinoma group,31 cases of signet ring cell carcinoma group,and 41 cases of adenocarcinoma.In this study,the basic clinical data of patients were analyzed first.Then retrospective analysis was performed on the differences of the three groups in the primary site of the tumor,gastric wall thickness,lesion size,tumor density,enhancement method(stratified/non-stratified),enhancement degree,and calcification.Results: 1.The three groups did not exhibit any noteworthy discrepancies in terms of age and gender(P > 0.05).2.The tumor site,lesion size,and thickness did not display any significant variations across diverse categories of gastric cancer(P > 0.05).3.Gastric wall thickening was observed in 93.5%(29/31)of gastric mucinous adenocarcinoma,77.4%(24/31)of signet ring cell carcinoma,and 90.2%(37/41)of non-mucinous adenocarcinoma,while the thickening and abnormal enhancement were not obvious on CT images in the remaining cases.There were significant differences among the three groups(P < 0.05),among which there were statistically significant differences among the mucinous adenocarcinoma group,signet ring cell carcinoma group and non-mucinous adenocarcinoma group.Mucinous adenocarcinoma typically showed low density in the middle layer of the gastric wall,while signet ring cell carcinoma and non-mucinous adenocarcinoma groups mainly showed substantial thickening of the gastric wall with relatively high density,and the tumor density was significantly different among all groups(P < 0.05).4.Hierarchical enhancement was observed in 51.6% of gastric mucinous adenocarcinoma group,16.7% of sig-ring cell carcinoma group,and no hierarchical enhancement was observed in non-mucinous adenocarcinoma group.Mild to moderate enhancement was observed in 55.1% of the gastric mucinous adenocarcinoma group,37.5% of the sigma-ring cell carcinoma group,and 18.9% of the non-mucinous adenocarcinoma group and 73.2% of the non-mucinous adenocarcinoma group.There were statistically significant differences among the above groups(P < 0.05),and gastric mucinous adenocarcinoma group and non-mucinous adenocarcinoma group(P < 0.001).5.Calcification features only appeared in the mucinous adenocarcinoma group and sigma-ring cell carcinoma group,but the frequency was low,and the difference between the two groups was not statistically significant.6.For TNM staging,CT staging was in good agreement with surgical and pathological staging,with the highest Kappa value of 0.799(P < 0.001).Conclusions: 1.There are significant differences between mucinous adenocarcinoma and sig-ring cell carcinoma in the focus density,enhancement mode,enhancement degree and other CT features,which can be accurately identified by multi-slice spiral CT.2.There are significant differences between mucinous adenocarcinoma and non-mucinous adenocarcinoma in focus density,enhancement mode,enhancement degree,calcification and other CT features,which can be accurately identified by multi-slice spiral CT.3.Multislice spiral CT has high value in staging diagnosis of gastric cancer. |
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