Gastroduodenal Glomus Tumors: Differentiation From Other Subepithelial Lesions Based on Dynamic Contrast-Enhanced CT Findings
| Autor: | Sung Eun Rha, Jin-Young Choi, So Yeon Kim, Se Hyung Kim, Joon Koo Han, Byung Ihn Choi, Bo Yun Hur, Min Woo Lee |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Necrosis Gastrointestinal Stromal Tumors Iohexol Contrast Media Choristoma Statistics Nonparametric Diagnosis Differential Lesion symbols.namesake Duodenal Neoplasms Stomach Neoplasms medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Pancreas Fisher's exact test Aged Retrospective Studies Aged 80 and over Aorta Chi-Square Distribution Leiomyoma business.industry General Medicine Middle Aged Glomus Tumor medicine.disease Glomus tumor medicine.anatomical_structure ROC Curve symbols Female Tomography medicine.symptom Tomography X-Ray Computed business Neurilemmoma Calcification |
| Zdroj: | American Journal of Roentgenology. 197:1351-1359 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | The purpose of this study was to describe the CT features of gastroduodenal glomus tumors and determine the CT features differentiating glomus tumors from other subepithelial lesions.CT images of 89 pathologically proven small (≤ 5 cm) gastroduodenal glomus tumors (n = 11), gastrointestinal stromal tumors (n = 44), schwannomas (n = 15), ectopic pancreata (n = 12), and leiomyomas (n = 7) were retrospectively reviewed. For subjective analysis, location, shape, growth pattern, enhancement pattern, and presence of necrosis, calcification, and surface ulceration were analyzed. For objective analysis, the long and short diameters of the lesion, ratio of long to short diameter, thickness of the overlying layer, CT attenuation of the lesion and aorta, and lesion-to-aorta ratio in the arterial, portal venous, and equilibrium phases were measured. Among these findings, significant CT variables were determined with the chi-square, Fisher exact, and Student t tests. Receiver operating characteristic analysis was used to determine the optimal cutoff values of thickness of the overlying layer and lesion-to-aorta ratio that differentiate glomus tumor from other subepithelial lesions.Typical location (antrum and duodenum), hemangioma-like enhancement pattern, overlying layer thickness 2.6 mm or greater, and portal venous phase lesion-to-aorta ratio 0.86 or greater were found to be significant variables for differentiating glomus tumors from other subepithelial lesions (p0.05). Among these CT findings, location and portal venous phase lesion-to-aorta ratio 0.86 or greater were highly sensitive findings for glomus tumor, and a hemangioma-like enhancement pattern was highly specific. All odds ratios were infinity. The odds ratio of overlying layer thickness of 2.6 mm or greater was 12.2 (95% CI, 2.9-51.8).A subepithelial lesion with a lesion-to-aorta ratio less than 0.86 in the portal venous phase or not in the gastric antrum or duodenum is never a glomus tumor. On the contrary, a subepithelial lesion with hemangioma-like enhancement during dynamic CT is essentially a glomus tumor. On the basis of these CT findings, glomus tumor can be differentiated from other subepithelial lesions with high diagnostic accuracy. |
| Databáze: | OpenAIRE |
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