[The stepchild of intestinal diagnosis. Evaluation of radiologic methods in the diagnosis of leiomyoma of the small intestine].
OBJECTIVE
Various radiological methods to diagnose small bowel neoplasms and problems of differential diagnosis specially considering leiomyomas are discussed.


METHODS
Two patients with leiomyoma of the ileum underwent enteroclysis, computed tomography of the abdomen, intra-arterial DSA and colour Doppler sonography. Another patient with leiomyosarcoma just underwent CT of the abdomen with CT-guided biopsy.


RESULTS
Due to the homogenous density and the smooth surface of the tumors in computed tomography and respectively enteroclysis and the presentation of the tumor vascularisation in the angiography and Colour Doppler sonography in both patients a leiomyoma of the small bowel was diagnosed. Postoperatively this diagnosis was histologically confirmed. The CT-findings of the patient with leiomyosarcoma were not suspicious of a malignant tumor.


CONCLUSIONS
Radiologically it is not possible to determine the dignity of smooth muscle cell tumors safely. That is the reason why the diagnosis has to be achieved operatively. But the histopathological diagnosis based on the mitotic rate may be difficult. Therefore the after care has to be carried out thoroughly.
Keberle
M
M
Institut für Röntgendiagnostik der Universität Würzburg.
Wittenberg
G
G
Jenett
M
M
Müller
J G
JG
Hahn
D
D
D000368:Aged; D003113:Colonoscopy; D005773:Gastroscopy; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007082:Ileum / Q000473:pathology / Q000601:surgery; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007889:Leiomyoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008643:Mesentery / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011875:Radionuclide Angiography; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color