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| Diagnostic value of MSCT and EUS in gastrointestinal mesenchymal tumors |
| LI Qian-yun, GAO Yan, CAI Hong-fang, XIE Cai-ping, FAN Shu-feng |
| Taizhou Hospital, Linhai Zhejiang 317000, China |
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Abstract Objective: To investigate the manifestation of gastrointestinal mesenchymal tumors(GIMTs) in 16-row spiral CT and EUS, and the diagnostic value of MSCT and EUS in GIMTs. Methods: Thirty-seven patients with pathologically proved GIMTs were analyzed retrospectively. Plain scan in 37 cases, two-phase dynamic enhanced spiral CT in 35 cases and EUS in 17 cases were made before surgery. Results: Among those there were 31 GISTs(19 in the stomach and 1, 6, 1, 4 in the esophagus, duodenum, colon and outsides gastrointestinal tract respectively), leiomyoma 4 cases(3 in the esophagus and 1 in the stomach), stomach schwannoglioma 2 cases. ①The important CT features were as follow: tumors with abundant vascularity in submucosa inclined to exophytic, showed necrosis, cystic degeneration, hemorrhage and calcifications, with no lymphnode metastasis. The benign and potential malignant GISTs displayed homogeneous enhancement with well-defined borders. The diameter of most tumor was 1.0～3.0cm(mean 2.16cm) in benign GIMTs and 1.2～3.5cm(mean 2.24cm) in potential malignant GIMTs. The malignant GIMTs exhibited inhomogeneous enhancement and invasion to adjacent organs. The diameter varied from 3.5cm to 16.0cm(mean 6.9cm) in malignant GIMTs. Accuracy of CT diagnosis for qualitative analysis was 20/37(54.05%) and for location was 30/37(81.08％) of GIMTs. ②Endoscopic and EUS characteristics: endoscopically, GIMTs had the following appearances: submucosal protuberance. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Benign tumors had homogeneous internal echoes with smooth margin, and the diameter varied from 0.5cm to 3.5cm(mean 1.75cm). The malignant lesions showed heterogeneous internal echoes, with or without fluid low echo, irregular border, and infiltration of the mesentery. The diameter ranged from 6.0cm to 10cm(mean 9.2cm). The accuracy of diagnosis for qualitative analysis was 15/17(88.24％) and for location was 16/17(94.12%) of GIMTs. Conclusion: MSCT and EUS were the two most valuable imaging modalities in assessing GIMTs and they could provide useful informations for exactly showing the layer of origin, location, tumor diameter, shape, border characteristics, internal echo patterns and invasion of GIMTs, these were useful to differentiate benign from malignancy, to direct management and to predict prognosis in patients with GIMTs.
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Received: 03 September 2007
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2008, Vol. 19 
