title: Multidetector CT of high-risk patients with occult gastrointestinal stromal tumors.
abstract: OBJECTIVE
  Stromal tumors are an important cause of occult gastrointestinal bleeding in patients who are middle aged or older. This study evaluated the size at which stromal tumors become symptomatic and necrotic and examined the role and limitations of multidetector CT in detecting gastrointestinal stromal tumors.
  
  
  METHODS
  Two hundred seventy-one patients with stromal tumors were retrospectively studied to examine the size of symptomatic, necrotic, or malignant stromal tumors. Next, five asymptomatic family members with germline c-kit mutations were prospectively screened to evaluate the role and limitations of multidetector CT.
  
  
  RESULTS
  In this retrospective study, two thirds of the patients with stromal tumors had symptoms and signs that were correlated with tumor size. Stromal tumors larger than 3 cm were accompanied by necrosis, whereas this finding was rare for those smaller than 3 cm. In the prospective screening, multidetector CT with IV infusion of contrast material showed gastrointestinal stromal tumors of more than 2 cm as slightly enhanced intramural or extramural nodules and also detected most gastrointestinal stromal tumors between 1 and 2 cm. Stromal tumors of less than 3 cm were not accompanied by necrosis and appeared as slightly enhanced homogenous tumors with the administration of contrast media.
  
  
  CONCLUSIONS
  Screening with multidetector CT should be feasible for detecting symptomatic stromal tumors of unknown location in the gastrointestinal tract.
authors.affiliation: Department of Surgery, E1, Osaka University Graduate School of Medicine, Yamada-oka 2-2, Suita 565-0871, Japan.
authors.forename: Toshirou
authors.initials: T
authors.lastname: Nishida
authors.forename: Seishi
authors.initials: S
authors.lastname: Kumano
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugiura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ikushima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Toshinori
authors.initials: T
authors.lastname: Ito
authors.forename: Hikaru
authors.initials: H
authors.lastname: Matsuda
mesh_terms: D003287:Contrast Media; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000235:genetics; D018095:Germ-Line Mutation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D019009:Proto-Oncogene Proteins c-kit