Value of mesenteric CT angiography in diagnosis of small intestinal neoplasms / 中华放射学杂志

ABSTRACT

Objective To investigate the value of mesenteric vascular CTA in the diagnosis of small intestinal neoplasms.Methods A retrospective analysis of mesenteric CTA from January 2008 to April 2013 was conducted in 51 patients with pathologically proven small intestinal neoplasms.Features of intestinal neoplasms CTA signs including neoplasm feeding artery,draining vein,mesangial side vasa recta and the formed neoplasm vessels,were observed.Two radiologists individually used two methods,namely intestinal tumor feeding artery positioning method and Cole fractionation method,for diagnosis and localization diagnosis of tumor,and also for comparing the results with those of surgical pathology.McNemar Chi-square test was adopted to evaluate the diagnosis differences between the two physicians and between the two methods by the same physician.Kappa value was used to assess the consistency of the results.Results Features of intestinal tumors CTA signs12 cases of enlarged neoplasm feeding artery,9 cases of early displayed draining vein,22 cases of enlarged mesangial side vasa recta,and 11 cases of vessels formed inside and around the neoplasm,single lesion for all and the largest lesion diameter≥ 5 cm for 37 cases.The accuracy of Cole fractionation method positioning and the feeding artery positioning were 84.31％(43/51) and 98.03％(50/51) respectively.Moderate consistency(Kappa=0.49,P＜0.01) was seen with Cole fractionation method by the two physicians and high consistency(Kappa=1.00,P＜0.01) with feeding artery positioning method.McNemar Chi-square test showed no significant difference between the two methods by the same physician and the consistency of the results from the two methods was passable(P were 0.062 and 0.125).Conclusion Mesenteric CTA can display the intestinal tumor feeding arteries and draining veins,and is helpful in identification of the relationship between the tumor and its surrounding blood vessels,which can improve the accuracy of pre-operative localization and qualitative diagnosis for small intestinal tumor.