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Computed tomography of gastrohepatic ligament involvement by gastric carcinoma

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Abstract

Purpose

This study was aimed to analyze the contrast-enhanced CT features of gastrohepatic ligament (GHL) involvement in gastric carcinoma (GC) and to evaluate the influence of GHL on the spread of GC correlating with the anatomic bases.

Methods

CT scans of 41 patients known to have GC and GHL involvement were reviewed retrospectively for the primary tumor and the GHL abnormalities, as well as the role GHL played in the spread of GC. Emphasis was placed on direct invasion, lymph node metastasis, and GHL seeding. The relationship between the accompanying ascites and the different pattern of the GHL involvement were also evaluated statistically.

Results

CT features of the GHL abnormalities caused by GC could be summarized as follows: (a) direct invasion (34.1%, 14 of 41), which was visualized as a regional (nine of 14) or diffuse mass (five of 14) in the GHL; (b) GHL seeding (26.8%, 11 of 41), which consists of ‘‘smudged’’ appearance (eight of 11), nodular infiltration (two of 11) and “GHL caking” (one of 11); (c) lymph node metastasis (63.4%, 26 of 41), including enlargement of lymph nodes (22 of 26) and cystic lesion (four of 26). We also found direct extension of GC into the transverse fissure and/or the liver via the GHL in three patients. Ascites, which was found in ten patients, seemed to be associated with the pattern of seeding involvement.

Conclusions

GHL can be invaded by GC through several patterns and contrast-enhanced CT scan plays an important role in detecting GHL involvement in GC, which has a variety of CT manifestations. GHL may also serve as a potential conduit for the predictable spread of GC into the neighboring organs such as the liver.

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References

  1. Kim S, Kim TU, Lee JW, et al. (2007) The perihepatic space: comprehensive anatomy and CT features of pathologic conditions. Radiographics 27:129–143

    Article  PubMed  Google Scholar 

  2. Yoo E, Kim JH, Kim MJ, et al. (2007) Greater and lesser omenta: normal anatomy and pathologic processes. Radiographics 27:707–720

    Article  PubMed  Google Scholar 

  3. Kim YH, Lee KH, Park SH, et al. (2009) Staging of T3 and T4 gastric carcinoma with multidetector CT: added value of multiplanar reformations for prediction of adjacent organ invasion. Radiology 250:767–775

    Article  PubMed  Google Scholar 

  4. Kim HJ, Kim AY, Oh ST, et al. (2005) Gastric cancer staging at multi-detector row CT gastrography: comparison of transverse and volumetric CT scanning. Radiology 236:879–885

    Article  PubMed  Google Scholar 

  5. Habermann CR, Weiss F, Riecken R, et al. (2004) Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US. Radiology 230:465–471

    Article  PubMed  Google Scholar 

  6. Fukuya T, Honda H, Hayashi T, et al. (1995) Lymph-node metastases: efficacy for detection with helical CT in patients with gastric cancer. Radiology 197:705–711

    PubMed  CAS  Google Scholar 

  7. Williams PL, Bannister LH, Berry MM (1995) Gray’s anatomy, 38th edn. Edinburgh: Churchill Livingstone

    Google Scholar 

  8. DeMeo JH, Fulcher AS, Austin RF Jr (1995) Anatomic CT demonstration of the peritoneal spaces, ligaments, and mesenteries: normal and pathologic processes. Radiographics 15:755–770

    PubMed  CAS  Google Scholar 

  9. Oliphant M, Berne AS, Meyers MA (1995) Direct spread of subperitoneal disease into solid organs: radiologic diagnosis. Abdom Imaging 20:141–147; discussion 148

    Google Scholar 

  10. Oliphant M, Berne AS, Meyers MA (1996) The subperitoneal space of the abdomen and pelvis: planes of continuity. Am J Roentgenol AJR 167:1433–1439

    Article  CAS  Google Scholar 

  11. Meyers MA, Volberg F, Katzen B, et al. (1973) Haustral anatomy and pathology: a new look. I. Roentgen identification of normal patterns and relationships. Radiology 108:497–504

    PubMed  CAS  Google Scholar 

  12. Meyers MA, Volberg F, Katzen B, et al. (1973) Haustral anatomy and pathology: a new look. II. Roentgen interpretation of pathological alterations. Radiology 108:505–512

    PubMed  CAS  Google Scholar 

  13. Meyers MA, Oliphant M, Berne AS, et al. (1987) The peritoneal ligaments and mesenteries: pathways of intraabdominal spread of disease. Radiology 163:593–604

    PubMed  CAS  Google Scholar 

  14. Jin H, Min PQ (2007) Computed tomography of gastrocolic ligament: involvement in malignant tumors of the stomach. Abdom Imaging 32:59–65

    Article  PubMed  CAS  Google Scholar 

  15. Tomimatsu H, Kanematsu M, Goshima S, et al. (2012) Uneven haustra on CT colonography: a clue for the detection of transperitoneal invasion from gastric cancer. Abdom Imaging 37:570–574

    Article  PubMed  Google Scholar 

  16. Jin H, Min PQ, Yang ZG, et al. (2008) A study of multi-detector row CT scan on greater omentum in 50 individuals: correlating with anatomical basis and clinical application. Surg Radiol Anat 30:69–75

    Article  PubMed  Google Scholar 

  17. Maruyama K, Kaminishi M, Hayashi K, et al. (2006) Gastric cancer treated in 1991 in Japan: data analysis of nationwide registry. Gastric Cancer 9:51–66

    Article  PubMed  Google Scholar 

  18. Maehara Y, Kakeji Y, Oda S, et al. (2000) Time trends of surgical treatment and the prognosis for Japanese patients with gastric cancer. Br J Cancer 83:986–991

    Article  PubMed  CAS  Google Scholar 

  19. Sakuramoto S, Sasako M, Yamaguchi T, et al. (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357:1810–1820

    Article  PubMed  CAS  Google Scholar 

  20. Tamura S, Miki H, Okada K, et al. (2010) Pilot study of a combination of S-1 and paclitaxel for patients with peritoneal metastasis from gastric cancer. Gastric Cancer 13:101–108

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by the Science Foundation of the 5th people’s Hospital of Shanghai (Grant No: 2010YJ10).

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Authors and Affiliations

  1. Department of Radiology, The 5th People’s Hospital of Shanghai, Fudan University, Shanghai, 200240, China

    Mei-Ying Ge, Hua-Bin Yin, Kai-Ming Wan & Jing-Fang Ge

  2. Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Medical Imaging Institute, 180#, Feng Lin Road, Shanghai, 200032, China

    Hang Jin

  3. Department of Medical Imaging, Shanghai College of Medicine, Fudan University, Shanghai, 200032, China

    Hang Jin

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  1. Mei-Ying Ge
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  2. Hua-Bin Yin
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  3. Kai-Ming Wan
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  4. Jing-Fang Ge
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  5. Hang Jin
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Correspondence to Hang Jin.

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Ge, MY., Yin, HB., Wan, KM. et al. Computed tomography of gastrohepatic ligament involvement by gastric carcinoma. Abdom Imaging 38, 697–704 (2013). https://doi.org/10.1007/s00261-013-9985-8

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