Difference of computed tomographic characteristic findings between gastric and intestinal gastrointestinal stromal tumors

Jpn J Radiol. 2020 Aug;38(8):771-781. doi: 10.1007/s11604-020-00962-0. Epub 2020 Apr 4.

Abstract

Purpose: We aimed to compare the computed tomography (CT) imaging differences between gastric and intestinal gastrointestinal stromal tumors (GISTs).

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Computed tomography; Gastrointestinal neoplasms; Gastrointestinal stromal tumors; Intestine; Stomach.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrointestinal Stromal Tumors / diagnostic imaging*
  • Humans
  • Intestinal Neoplasms / diagnostic imaging*
  • Intestines / diagnostic imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach / diagnostic imaging
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology
  • Tomography, X-Ray Computed / methods*