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A Comparative Study on Superselective Angiography and Microangiography of the Gastric Cancer M. Kitajima 1 , Y. Uematsu 1 , M. Ochiai 2 , K. Maruyama 3 , K. Hiramatsu 4 1Department of Surgery, Ashikaga Red Cross Hospital 2Department of Surgery, School of Medicine, Keio University 3Department of Surgery, National Cancer Center 4Department of Radiology, School of Medicine, Keio University pp.513-522
Published Date 1975/4/25
DOI https://doi.org/10.11477/mf.1403112305
  • Abstract
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 Recently the angiographic diagnostic method has made a remarkable progress as an effective method of identifying cancers of various organs. However, there were few discussions concerning the studies of angio-graphic vascular patters in the tumor vessels. In order to elucidate this problem, we have selected gastric cancer because of its extremely variegated histology and morphology. Utilizing Seldinger techniques, we have carried out comparative studies between the superselective angiographical patterns, especially of the left gastric artery, and microangiographical pictures of the resected specimen in the same patients.

 Superselective angiography was performed exclusively on 3 patients with cardiac cancer, 17 patients with advanced cancer (5 cases Borrmann Ⅱ, 10 of Borrman Ⅲ and 2 of Borrman IV) and 5 patients with early cancer (1 case of type Ⅰ, 2 each of Ⅱc and Ⅱc+Ⅲ).

 Classification of the vascular patterns of tumors based on the angiographic pictures was (1) encasement, (2) vascular occlusion, (3) neovascularity, (4) tumor stain, (5) venous laking (lake) and (6) venous drainage. On the other hand, microangiography revealed that vascular pattern of gastric cancer, different from that of the normal stomach, showed special vascular architectures. Besides, the vascular pattern varies according to the types of lesions, degrees of invasion and histopathologic findings as follows:

 1. Seen from the degree of vascular density, cancers are classified into hypervascular and hypovascular types.

 2. The tumor vessels are tortuous, narrow or straight according to the histology of the tumors. Although differences exist in the level of the contrast medium between angiography and microangiography, comparative studies show that encasement represent direct infiltration into the vessels of the subserous and submucosal layers. Vascular occlusion results from the isolation and congestion of the same vessels. Neovascularity shows tumor vessels of hypervascular cancer with congestion in the borders of the tumor. In the case of tumor stain, findings are almost similar to those of neovascularity. Venous laking is interpreted as congestion of the borders of the tumor, while venous drainage is presumed to be due to the formation an arterio-venous fistula with descructive development of cancer at the borders of the tumor.


Copyright © 1975, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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