Department of Radiology, Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
Department of Surgery, Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
Jpn J Radiol. 2020 Aug;38(8):771-781. doi: 10.1007/s11604-020-00962-0. Epub 2020 Apr 4.
We aimed to compare the computed tomography (CT) imaging differences between gastric and intestinal gastrointestinal stromal tumors (GISTs).
Thirty-eight patients with 38 gastric GISTs and 27 with 31 intestinal GISTs were enrolled. Tumors were classified as small (< 5 cm) or large (≥ 5 cm). Qualitative and quantitative CT imaging characteristics on non-contrast and contrast-enhanced CT were evaluated by two radiologists independently and statistically compared.
Early venous return and higher CT number of the draining vein in the arterial phase were more frequent in small-sized intestinal GISTs than in small-sized gastric GISTs (p < 0.001). Small-sized intestinal GISTs demonstrated a wash-out pattern, whereas small-sized gastric GISTs showed a plateau pattern. Contrast enhancement was higher in small-sized intestinal GISTs than in small-sized gastric GISTs (p < 0.001). CT number was inversely proportional to the diameter of intestinal GISTs in both arterial and venous phases but not to that of gastric GISTs.
Strong enhancement with wash-out pattern and early venous return are characteristic findings of small-sized intestinal GISTs. Radiologists should be aware that CT findings of GISTs have a wide spectrum and may differ according to size and site of origin.
比较胃和肠胃肠道间质瘤（GIST）的计算机断层扫描（CT）成像差异。
纳入 38 例胃 GIST 和 27 例肠 GIST 患者，肿瘤分为小（<5cm）和大（≥5cm）。由两位放射科医生独立评估非增强和增强 CT 的定性和定量 CT 成像特征，并进行统计学比较。
小尺寸肠 GIST 在动脉期较早出现静脉回流和引流静脉的 CT 值较高，而小尺寸胃 GIST 则呈平台型（p<0.001）。小尺寸肠 GIST 呈洗脱模式，而小尺寸胃 GIST 呈平台模式。小尺寸肠 GIST 的增强程度高于小尺寸胃 GIST（p<0.001）。在动脉期和静脉期，CT 值与肠 GIST 的直径呈反比，但与胃 GIST 的直径无关。
强化明显伴洗脱模式和早期静脉回流是小尺寸肠 GIST 的特征性表现。放射科医生应意识到 GIST 的 CT 表现具有广泛的谱，并且可能因大小和起源部位而异。
