Role of multislice computed tomography imaging in gastrointestinal stromal tumors.

Dr Varsha Rangankar; Dr Abhijit Pawar; Brig Dr Hariqbal Singh

Volume : VI, Issue : III, March - 2016

Role of multislice computed tomography imaging in gastrointestinal stromal tumors.

Dr Varsha Rangankar, Dr Abhijit Pawar, Brig Dr Hariqbal Singh

Abstract :

Aim of study:The purpose of this study was to assess the multislice computed tomography (MSCT) imaging features of the gastrointestinal stromal tumors. Material and methods:MSCT images of total 37 patients (38 lesions) of gastrointestinal stromal tumors (GISTs) were retrospectively analyzed during the period of October 2011 to December 2015. The images were evaluated for site of tumor origin, size, margins, growth pattern, attenuation and enhancement pattern and presence of necrosis in the lesion, perilesional fat infiltration, relation with adjacent structures, lymphadenopathy and metastases. Results:Thirty seven patients between the ages of 37 to 70 years diagnosed with GIST were studied which included 21 (56.8 %) men and 16 (43.2 %) women. One patient had two lesions involving stomach and duodenum respectively. Out of the 38 lesions, the tumor was located in stomach in 18 (47.3 %), duodenum in 5 (13.1 %), small bowel in 8 (21 %), large bowel in 2 (5.3 %), and omentum and mesentery in 5 (13.1 %) cases. The size of lesion ranged from 4 to 30 cm with mean size of 10.9 cm. The margins of the tumor were well defined regular in 22 (57.9 %) lesions, well defined lobulated in 13 (34.2 %) and ill–defined irregular in 3 (7.9 %) lesions. Out of 38 lesions, 26 (68.4 %) showed extraluminal growth pattern while 12 (31.6 %) tumors had extra as well as intraluminal growth. The tumors had CT attenuation in the range of 10 to 55 HU with mean attenuation value of 37.5 HU. Homogeneous enhancement pattern was seen in 8 (21%) tumors while 30 (79%) lesions showed heterogeneous enhancement. The perilesional fat infiltration was present in 14 (36.8%) tumors and loss of fat planes with adjacent structures was seen in 12 (31.6 %) lesions. Four patients (10.8 %) had associated lymphadenopathy while metastases were present in 6 (16.2%) cases. Two (5.2 %) patients had intestinal obstruction at the time of presentation and ascites was seen in 14 (37.8%) patients. Conclusion: The diagnosis of GISTs on CT imaging could be made reliably in presence of large well–defined predominantly exophytic tumor with heterogeneous enhancement and cystic necrosis. MSCT imaging plays an important role in detection, characterization and staging of GISTs.