1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China.
AJR Am J Roentgenol. 2015 May;204(5):988-93. doi: 10.2214/AJR.14.12870.
Diagnosis and staging of duodenal gastrointestinal stromal tumors (GISTs) by noninvasive imaging is critical for effective treatment, but the imaging features of duodenal GISTs remain largely undefined because of their rarity. The purpose of this article was to characterize duodenal GISTs using CT.
Thirty-four patients with duodenal GISTs were analyzed by clinical symptom evaluation, pathologic examination, and CT in this retrospective study. Unenhanced and contrast-enhanced examinations were performed in all patients. Imaging characteristics, including the lesion location, size, growth pattern, ulceration, internal components, arterial blood supply, intratumoral arterioportal shunting, intratumoral vessels, rim enhancement, and enhancement patterns were reviewed.
The duodenal GISTs were solitary masses with well-defined margins. The average diameter was 7.1 cm. The second portion was the most common site (20/34). Ulceration was a common feature (15/34). Calcification was uncommon (3/34), and mixed growth pattern was more common (26/34). Rim enhancement (24/34) and mixed enhancement pattern (15/34) were common. Arterial blood supply, intratumoral vasculature, and draining veins were all detected and were obvious on the arterial phase. The portal venous trunk and superior mesenteric vein were the main veins into which early arterioportal shunting drained.
Primary duodenal GISTs are generally large, well-defined, heterogeneously enhancing, and hypervascular masses with a prominent mixed growth pattern on CT images. Our findings suggest that CT can help depict the origin of the tumoral arteries and draining veins on the arterial phase and may be a key defining diagnostic feature for duodenal GISTs.
通过非侵入性影像学诊断和分期十二指肠胃肠道间质瘤（GISTs）对于有效治疗至关重要，但由于其罕见性，十二指肠 GISTs 的影像学特征仍在很大程度上尚未确定。本文旨在通过 CT 对十二指肠 GISTs 进行特征描述。
在这项回顾性研究中，通过临床症状评估、病理检查和 CT 对 34 例十二指肠 GIST 患者进行了分析。所有患者均进行了未增强和增强检查。回顾性分析了包括病变位置、大小、生长方式、溃疡、内部成分、动脉血供、肿瘤内动静脉分流、肿瘤内血管、边缘强化和强化模式等影像学特征。
十二指肠 GISTs 为边界清楚的单发肿块。平均直径为 7.1cm。第二部分是最常见的部位（20/34）。溃疡是常见特征（15/34）。钙化不常见（3/34），混合生长方式更常见（26/34）。边缘强化（24/34）和混合强化模式（15/34）较为常见。动脉期均能检测到肿瘤的供血动脉、肿瘤内血管和引流静脉，且显示明显。门静脉主干和肠系膜上静脉是早期动静脉分流的主要引流静脉。
原发性十二指肠 GISTs 通常为边界清楚、大小不等、不均匀强化、富血供的肿块，CT 图像上具有明显的混合生长方式。我们的研究结果表明，CT 有助于描绘动脉期肿瘤动脉和引流静脉的起源，可能是诊断十二指肠 GISTs 的关键特征。
