Gastrointestinal stromal tumours: experience with multislice CT

Abstract

The aim of this study was to evaluate the possibilities of multislice computed tomography (MSCT) in the identification and characterisation of gastrointestinal stromal tumours (GISTs). MSCT images of 27 patients affected by GIST were analysed. MSCT scans were performed before and after contrast medium injection, and bowel distension was obtained with the administration of water, air or a diluted Gastrografin solution. Images were evaluated for presence and site of the tumour, origin and growth pattern relative to the bowel wall, density, relationship with adjacent structures and evidence of lymph nodes and metastases. GISTs were located in the stomach in 18/27 patients, in the small bowel in seven, in the oesophagus in one and in the rectum in one. Tumour size ranged from 1.5 cm to 21 cm. An extramucosal origin was definitely established in 23/27 cases. In 15/27 cases, the lesions exhibited extramural growth, and in 17/27 cases, they were homogeneous after contrast medium injection. The borders were regular in 17 cases. Hepatic metastases were detected in 5/27 cases, and lymphadenomegaly was found in one case only. Nowadays, MSCT can be considered an essential tool for the diagnosis of GISTs, as it enables one to detect the disease, define its relationships and search for possible metastases.