Objective: To investigate the ability of contrast enhanced multiple-row detector computed tomography(ceMDCT) in the determination of extramural venous invasion (EMVI) in patients with gastric cancer and to analyze associated factors of EMVI.
Methods: From January 2009 to December 2013, 253 patients with gastric cancer undergoing ceMDCT in Peking University People's Hospital were included in this study. The imaging characteristics and clinical data were retrospectively reviewed. Positive or negative EMVI on ceMDCT(ctEMVI) was determined according to the EMVI scores criteria defined by MR high resolution image of rectal cancer. Chi-square test was used to analyze the associations of ctEMVI with other images and clinicopathological data.
Results: The positive rate of ctEMVI was 32.8%(83/253) according to the EMVI scores criteria. Positive ctEMVI was associated with following CT findings, such as ctT (χ(2)=46.848, P=0.000), ctN (χ(2)=41.095, P=0.000), ctM (χ(2)=23.864, P=0.000), tumor growth pattern (χ(2)=8.580, P=0.003), tumor sizes (χ(2)=21.177, P=0.000), and with pathological T staging (χ(2)=28.994, P=0.000) and N staging (χ(2)=28.671, P=0.000), while no association with age, gender, histological type and tumor differentiation were seen(all P>0.05).
Conclusions: ceMDCT can be used to detect ctEMVI in patients with gastric cancer. ctEMVI is associated with invasion depth, lymph node metastasis, distant metastasis, tumor size, tumor location and growth pattern.