Analysis of the value of CT and EUS in diagnosing gastrointestinal stromal tumors / 中华放射学杂志

ABSTRACT

Objective To investigate the value of CT and endoscopic ultrasonography (EUS) in the diagnosis of gastrointestinal stromal tumors (GIST). Methods Eleven patients with surgically and pathologically proved GIST were collected and retrospectively analyzed.Plain CT scanning was performed in all 11 cases and enhancement in 10 cases, while additional EUS in 8 cases.Results Of the 11 lesions, 8 were located in stomach, 1 in esophagus, 1 in duodenum, and 1 in rectum, respectively.In benign GIST, the diameter of the tumor was less than 5 cm, with clear margin and homogeneous density.In malignant GIST, the characteristic appearances were as follows (1) The diameter of the tumor was more than 7 cm; (2) The tumor was lobular in shape; (3) Lesions contained intratumoral small or large patchy necrosis; (4) The tumor had large and deep ulcers; (5) Around the tumor, small vessels arranged in clumps or in line; (6) The tumor contained scattered small calcifications; (7) Invasion of adjacent tissues and metastasis.The positive predictive value of CT for location of GIST was 54.5% (6/11), the positive predictive value of EUS was 87.5% (7/8).By pathology, benign GIST was identified in 3 cases, malignant in 7 cases, and active proliferation in 1 case.The positive predictive value of CT for differentiation of benign and malignant GIST was 72.7% (8/11), the positive predictive value of EUS was 62.5% (5/8).Conclusion CT combined with EUS are helpful in evaluating the gastrointestinal origin of GIST, and in differentiating between benign and malignant GIST, and in instructing clinical treatment and estimating prognosis.