Multidetector CT of high-risk patients with occult gastrointestinal stromal tumors.
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.
Nishida
Toshirou
T
Department of Surgery, E1, Osaka University Graduate School of Medicine, Yamada-oka 2-2, Suita 565-0871, Japan.
Kumano
Seishi
S
Sugiura
Takashi
T
Ikushima
Hirofumi
H
Nishikawa
Kazuhiro
K
Ito
Toshinori
T
Matsuda
Hikaru
H
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
D003287:Contrast Media; D019009:Proto-Oncogene Proteins c-kit