Computed tomography-based contrast features for distinguishing extra-gastrointestinal stromal tumors from intra-abdominal fibromatosis.

IF 1.4 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Diagnostic and interventional radiology Pub Date : 2024-07-22 DOI:10.4274/dir.2024.242800

Lijing Zhang, Yongbo Li, Xinxin Luo, Deqi Li, Linlin Yin, Jiayue Li, Li Zhang

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Abstract

Purpose: This study aims to define the computed tomography (CT) criteria that distinguish extra-gastrointestinal stromal tumors (eGISTs) from intra-abdominal fibromatosis (IAF).

Methods: Retrospective analysis was conducted on CT images obtained from 31 pathologically confirmed cases, including 17 cases of eGISTs and 14 of IAF. Various parameters [e.g., lesion location, contour characteristics, border delineation, enhancement patterns, presence of intralesional necrosis, vessels, air, fat, and hemorrhage, the long diameter (LD), LD/short diameter (SD) ratio, and volume (LD × SD × height diameter)] were meticulously evaluated. In addition, the degree of enhancement during arterial and portal venous phases and the lesion-to-aorta CT attenuation ratio during both phases were quantified. Statistical analysis was performed using Fisher's exact test, the Student's t-test, and the receiver operating characteristic curve to identify significant CT criteria. Sensitivity and specificity assessments were conducted for single and combined CT criteria.

Results: Significant differentiators between eGISTs and IAF include non-mesenteric localization, irregular contour, well-defined borders, heterogeneous enhancement, presence of intralesional necrosis and vessels, and absence of intralesional fat, with LD exceeding 9.6 cm, an LD/SD ratio >1.22, and volume surpassing 603.3 cm³ (P < 0.05). A combination of seven or more of these criteria yielded a specificity of 100%.

Conclusion: Ten distinct CT criteria have been identified to distinguish eGISTs from IAF, notably encompassing non-mesenteric localization, irregular contour, well-defined borders, heterogeneous enhancement, presence of intralesional necrosis and vessels, absence of intralesional fat, LD >9.6 cm, an LD/SD ratio >1.22, and volume surpassing 603.3 cm³.

Clinical significance: The current findings establish CT criteria to distinguish eGISTs from IAF in a clinical setting.

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基于计算机断层扫描的对比特征，用于区分胃肠道外间质瘤和腹腔内纤维瘤病。

目的：本研究旨在确定区分胃肠道外间质瘤（eGISTs）和腹腔内纤维瘤病（IAF）的计算机断层扫描（CT）标准：对31例病理确诊病例的CT图像进行回顾性分析，其中包括17例eGISTs和14例IAF。对各种参数[如病变位置、轮廓特征、边界划分、增强模式、是否存在区域内坏死、血管、空气、脂肪和出血、长径（LD）、LD/短径（SD）比值和体积（LD × SD × 高径）]进行了细致评估。此外，还量化了动脉期和门静脉期的增强程度以及两期病变与主动脉的 CT 衰减比。统计分析采用费雪精确检验、学生 t 检验和接收者操作特征曲线来确定重要的 CT 标准。对单一和组合 CT 标准进行了敏感性和特异性评估：eGISTs和IAF的重要鉴别标准包括：非肠系膜定位、轮廓不规则、边界清晰、异质强化、有组织内坏死和血管、无组织内脂肪、LD超过9.6厘米、LD/SD比值>1.22、体积超过603.3立方厘米（P<0.05）。综合上述标准中的七项或更多标准，特异性达到 100%：结论：已确定了十项不同的 CT 标准来区分 eGIST 和 IAF，主要包括非肠系膜定位、轮廓不规则、边界清晰、异质强化、存在区域内坏死和血管、无区域内脂肪、LD >9.6 cm、LD/SD 比值 >1.22 和体积超过 603.3 cm3：目前的研究结果确立了在临床环境中区分 eGIST 和 IAF 的 CT 标准。

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来源期刊

Diagnostic and interventional radiology Medicine-Radiology, Nuclear Medicine and Imaging

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4.80%

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期刊介绍： Diagnostic and Interventional Radiology (Diagn Interv Radiol) is the open access, online-only official publication of Turkish Society of Radiology. It is published bimonthly and the journal’s publication language is English. The journal is a medium for original articles, reviews, pictorial essays, technical notes related to all fields of diagnostic and interventional radiology.