Gastrointestinal Stromal Tumours: Role of Computed Tomography in Predicting Tumour Behaviour

Abstract

Objective: To describe the clinical and imaging features of the gastrointestinal stromal tumours and the role of computed tomography in predicting malignant potential.

Methods:The medical records and imaging features of the patients diagnosed with gastrointestinal stromal tumours at our institution were reviewed retrospectively. Imaging features were correlated with their clinical course, including the presence or subsequent development of metastatic disease.

Results:In all, 28 patients (mean age, 65.2 years) with pathologically proven gastrointestinal stromal tumours were included in the study. The stomach was the most common site followed by small bowel. The mean tumour diameter was 7.5 cm. Metastatic disease developed in nine patients. Computed tomography showed necrotic masses (n = 8) and heterogeneous contrast enhancement (n = 17). Large tumour size, heterogeneous enhancement and necrosis were independently associated with an increased risk of metastatic disease.

Conclusion: Gastrointestinal stromal tumours have fairly characteristic imaging features on computed tomography and the diagnosis can be suggested by imaging features. Computed tomography is potentially a valuable tool in the initial evaluation of such tumours and predicting their potential for malignant behaviour.

Alternate abstract:

目的：描述胃腸道間質瘤的臨床及影像特徵，以及電腦斷層造影在預測腫瘤惡性程度所扮演的角 色。

方法：回顧本院胃腸道間質瘤患者的臨床紀錄及影像特徵，並探討這些影像特徵是否與病人的臨床 病程有關，包括癌症轉移的出現或狀況。

結果：共回顧了28名病理證實患有胃腸道間質瘤的病人紀錄。患者平均年齡65.2歲，最普遍患癌的 位置為胃部，其次為小腸。腫瘤平均直徑為7.5 厘米。其中9名患者有癌症轉移。電腦斷層造影顯示8人有壞死性腫瘤，另17人有不均勻強化的顯影增強。大腫瘤、不均勻強化現象、和壞死均獨立與高 風險癌症轉移相關。

結論：胃腸道間質瘤在電腦斷層造影表現有一定的特徵性，醫生可憑這些造影特徵作診斷。電腦斷 層造影對胃腸道間質瘤的初步評估以及預測腫瘤惡性程度有重要價值。