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Abstract #3036

Sandwich Sign of Borrmann Type 4 Gastric Cancer on Diffusion-Weighted Magnetic Resonance Imaging

Lei Tang1, Xiao-Peng Zhang1, Ying-Shi Sun1, Zi-Yu Li2, Jia-Fu Ji2, Xiao-Ting Li1, Yi-Qiang Liu3

1Radiology, Peking University Cancer Hospital, Beijing, China; 2Gastroenterology Surgery, Peking University Cancer Hospital; 3Pathology, Peking University Cancer Hospital


Borrmann type 4 (BT-4) gastric cancer often infiltrates deep mucosa, which may lead to false negative results on endoscopic biopsy. In this study, we performed correlation of DWI with histopathology and comparison with conventional sequences, to see if it can provide additional information for the diagnosis of BT-4 gastric cancer. We found the cancer-to-stomach CNR on DWI was better than T1WI and T2WI. A three-layer sandwich sign that demonstrated high signal intensity in the inner and outer layer, and low signal intensity in the intermediate layer of BT-4 gastric cancer was observed on DWI. The mean ADC value of BT-4 gastric cancer was significantly lower than the poorly distended normal stomach wall. We concluded that DWI can provide useful information for the diagnosis of BT-4 gastric cancer.