title: CT Characterization of Duodenal Gastrointestinal Stromal Tumors.
abstract: OBJECTIVE
  Diagnosis and staging of duodenal gastrointestinal stromal tumors (GISTs) by noninvasive imaging is critical for effective treatment, but the imaging features of duodenal GISTs remain largely undefined because of their rarity. The purpose of this article was to characterize duodenal GISTs using CT.
  
  
  METHODS
  Thirty-four patients with duodenal GISTs were analyzed by clinical symptom evaluation, pathologic examination, and CT in this retrospective study. Unenhanced and contrast-enhanced examinations were performed in all patients. Imaging characteristics, including the lesion location, size, growth pattern, ulceration, internal components, arterial blood supply, intratumoral arterioportal shunting, intratumoral vessels, rim enhancement, and enhancement patterns were reviewed.
  
  
  RESULTS
  The duodenal GISTs were solitary masses with well-defined margins. The average diameter was 7.1 cm. The second portion was the most common site (20/34). Ulceration was a common feature (15/34). Calcification was uncommon (3/34), and mixed growth pattern was more common (26/34). Rim enhancement (24/34) and mixed enhancement pattern (15/34) were common. Arterial blood supply, intratumoral vasculature, and draining veins were all detected and were obvious on the arterial phase. The portal venous trunk and superior mesenteric vein were the main veins into which early arterioportal shunting drained.
  
  
  CONCLUSIONS
  Primary duodenal GISTs are generally large, well-defined, heterogeneously enhancing, and hypervascular masses with a prominent mixed growth pattern on CT images. Our findings suggest that CT can help depict the origin of the tumoral arteries and draining veins on the arterial phase and may be a key defining diagnostic feature for duodenal GISTs.
authors.affiliation: 1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China.
authors.forename: Pei-Qiang
authors.initials: PQ
authors.lastname: Cai
authors.forename: Xiao-Fei
authors.initials: XF
authors.lastname: Lv
authors.forename: Li
authors.initials: L
authors.lastname: Tian
authors.forename: Zhuo-Peng
authors.initials: ZP
authors.lastname: Luo
authors.forename: R Alan
authors.initials: RA
authors.lastname: Mitteer
authors.forename: Yi
authors.initials: Y
authors.lastname: Fan
authors.forename: Yao-Pan
authors.initials: YP
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D003287:Contrast Media; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
keywords: CT; characterization; duodenal; gastrointestinal stromal tumor (GIST)