Department of Radiology, Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu City, Shiga, 520-2192, Japan.
Department of Surgery, Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu City, Shiga, 520-2192, Japan.
Abdom Radiol (NY). 2019 Apr;44(4):1237-1245. doi: 10.1007/s00261-018-1865-9.
We aimed to reveal specific findings of gastrointestinal stromal tumors (GISTs) in the small intestine on contrast-enhanced computed tomography (CT) by comparing GISTs with non-GISTs.
We enrolled 28 patients with 39 GISTs and 20 patients with 22 non-GISTs who underwent enterectomy with a preoperative diagnosis of small intestinal tumor. All lesions were diagnosed by histopathological examination. Two radiologists independently evaluated internal homogeneity, growth pattern, calcification, intratumoral hemorrhage, degeneration, ulceration, and lymphadenopathy and measured the maximum diameter of the tumor and contrast-enhanced CT (CECT) value of the solid portion as well as the diameter and CT value of the feeding artery and drainage vein on CECT in the arterial and venous phases.
Intratumoral hemorrhage was seen in 15.4% and 25.6% of GISTs and in 0% and 0% of non-GISTs (p = 0.079 and 0.010), with good interobserver agreement (κ = 0.715). The drainage vein diameter correlated well with the maximum diameter of the tumor (r = 0.744, p < 0.001). The CT value of the solid tumor part in the arterial and venous phases (p < 0.01) and the CT value of the drainage vein in the arterial phase (p < 0.05) were higher for GISTs than for non-GISTs (p < 0.01).
Strong parenchymal enhancement with the peak in the arterial phase and the CT value of the drainage vein in the arterial phase was characteristics findings of GIST compared with non-GISTs. The diameter of the drainage vein was proportional to the maximum diameter of GISTs.
通过对比胃肠道间质瘤（GIST）与非 GIST，旨在揭示小肠增强 CT （CECT）上 GIST 的特定表现。
我们纳入了 28 例术前诊断为小肠肿瘤而行肠切除术的 39 例 GIST 患者和 20 例 22 例非 GIST 患者。所有病变均经组织病理学检查诊断。两名放射科医生独立评估内部均匀性、生长模式、钙化、瘤内出血、变性、溃疡和淋巴结病，并测量肿瘤的最大直径和实体部分的 CECT 值，以及动脉期和静脉期 CECT 上供血动脉和引流静脉的直径和 CT 值。
GIST 中瘤内出血分别为 15.4%和 25.6%，而非 GIST 中为 0%和 0%（p = 0.079 和 0.010），观察者间一致性良好（κ = 0.715）。引流静脉直径与肿瘤最大直径相关性良好（r = 0.744，p < 0.001）。动脉期和静脉期实体肿瘤部分的 CT 值（p < 0.01）和动脉期引流静脉的 CT 值（p < 0.05）均高于非 GIST（p < 0.01）。
与非 GIST 相比，GIST 的实质强化明显，呈动脉期高峰，引流静脉 CT 值在动脉期较高。引流静脉的直径与 GIST 的最大直径成正比。
