Zhu H, Chen H, Zhang S, Peng W. Intra-abdominal fibromatosis: differentiation from gastrointestinal stromal tumour based on biphasic contrast-enhanced CT findings.
Clin Radiol 2013;
68:1133-9. [PMID:
23953007 DOI:
10.1016/j.crad.2013.06.009]
[Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 05/14/2013] [Accepted: 06/14/2013] [Indexed: 12/15/2022]
Abstract
AIM
To identify the computed tomography (CT) criteria that differentiate intra-abdominal fibromatosis (IAF) from gastrointestinal stromal tumour (GIST).
MATERIALS AND METHODS
CT images of 34 pathologically proven cases of IAF (n = 15) and GIST (n = 19) were retrospectively reviewed. Location, contour, border, enhancement pattern, presence of necrosis, vessels, and air within the lesion were analysed. Long diameter (LD), short diameter (SD), LD/SD ratio, degree of enhancement, and lesion/aorta (L/A) CT attenuation ratio were measured and calculated. Significant CT criteria were identified using Fisher's exact test, grouped t-test, and receiver operating characteristic (ROC) curve. Sensitivity and specificity values were calculated when single or multiple CT criteria were used.
RESULTS
Extra-gastrointestinal location, ovoid or irregular contour, homogeneous enhancement, absence of intra-lesional necrosis, lower degree of enhancement, and L/A CT attenuation ratio differentiated IAF from GIST (p < 0.05). When any three of these eight criteria were combined, the sensitivity and specificity for diagnosing IAF were 100% (15 of 15) and 89.5% (17 of 19), respectively.
CONCLUSION
The following eight CT criteria are helpful to differentiate IAF from GIST: extra-gastrointestinal location, ovoid or irregular contour, homogeneous enhancement, absence of intra-lesional necrosis, a degree of enhancement of less than 40.5 HU in the arterial phase versus 46.5 HU in the portal venous phase, and an L/A CT attenuation ratio <0.315 in the arterial phase versus 0.525 in the portal phase.
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