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| Advances in the diagnosis of primary solid small bowel tumors by contrast-enhanced multislice spiral CT |
| CHEN Yingxiu1,2, LIU Qianqian1,2, JI Huijun1,2, CHEN Qi1,2, GU Mengyao1,2, LI Wanhu2 |
1. Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117 China;
2. Department of Medical Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117 China |
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Abstract Primary small bowel tumors have low incidence and contain predominantly solid components, and the lesions are similar and difficult to be detected and distinguished with multislice spiral CT (MSCT) plain scans. In this article we describe contrast-enhanced MSCT technique and imaging characteristics for solid small bowel tumors or small bowel tumors containing predominantly solid components, including the type and use of contrast agents. In contrast-enhanced MSCT, small bowel imaging with CT has the advantages of determining the true extent of intestinal wall lesions, the possible extent of wall penetration, the degree of mesenteric involvement, and distant metastases, as well as easiness to detect and identify the blood supply vessels of small bowel tumors and assessment of the corresponding complications. Contrast-enhanced MSCT has become the best noninvasive imaging technique for the diagnosis, evaluation, and staging of solid small bowel tumors or small bowel tumors containing predominantly solid components. CT texture analysis (CTTA) is a new research hotspot and can be useful for the correct diagnosis of primary small bowel tumors containing predominantly solid components.
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Received: 30 September 2022
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[1] Volk N, Lacy B. Anatomy and physiology of the small bowel[J]. Gastrointest Endosc Clin N Am, 2017, 27(1): 1-13. DOI: 10.1016/j.giec.2016.08.001
[2] Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021[J]. CA:Cancer J Clin, 2021, 71(1): 7-33. DOI: 10.3322/caac.21654
[3] Minordi LM, Binda C, Scaldaferri F, et al. Primary neoplasms of the small bowel at CT: a pictorial essay for the clinician[J]. Eur Rev Med Pharmacol Sci, 2018, 22(3): 598-608. DOI: 10.26355/eurrev_201802_14281
[4] Jasti R, Carucci LR. Small bowel neoplasms: a pictorial review[J]. Radio Graphics, 2020, 40(4): 1020-1038. DOI: 10.1148/rg.2020200011
[5] Kim SW, Kim HC, Oh J, et al. Tumors of the jejunum and ileum: a pattern-based imaging approach on CT[J]. Abdom Radiol, 2019, 44(7): 2337-2345. DOI: 10.1007/s00261-019-01978-5
[6] Anzidei M, Napoli A, Zini C, et al. Malignant tumours of the small intestine: a review of histopathology, multidetector CT and MRI aspects[J]. Br J Radiol, 2011, 84(1004): 677-690. DOI: 10.1259/bjr/20673379
[7] Hughes J, Lee A, Fong J, et al. Leiomyoma: a rare cause of small bowel obstruction[J]. ANZ J Surg, 2020, 90(6): 1165-1168. DOI: 10.1111/ans.15698
[8] Gill SS, Heuman DM, Mihas AA. Small intestinal neoplasms[J]. J Clin Gastroenterol, 2001, 33(4): 267-282. DOI: 10.1097/00004836-200110000-00004
[9] Ramai D, Tan QT, Nigar S, et al. Ulcerated gastric leiomyoma causing massive upper gastrointestinal bleeding: a case report[J]. Mol Clin Oncol, 2018, 8(5): 671-674. DOI: 10.3892/mco.2018.1597
[10] Schindler R, Blomquist OA. Leiomyosarcoma of the stomach; its roentgenologic and gastroscopic diagnosis and its possible relation to pernicious anemia[J]. Surg Gynecol Obstet, 1946, 82: 239-252
[11] Sokhandon F, Al-Katib S, Bahoura L, et al. Multidetector CT enterography of focal small bowel lesions: a radiological–pathological correlation[J]. Abdom Radiol, 2017, 42(5): 1319-1341. DOI: 10.1007/s00261-016-1015-1
[12] Maguire A, Sheahan K. Primary small bowel adenomas and adenocarcinomas-recent advances[J]. Virchows Arch, 2018, 473(3): 265-273. DOI: 10.1007/s00428-018-2400-7
[13] Williamson JML, Williamson RCN. Small bowel tumors: pathology and management[J]. J Med Assoc Thai, 2014, 97(1): 126-137
[14] Rengo M, Picchia S, Laghi A. Small bowel MDCT[M]//Nikolaou K, Bamberg F, Laghi A, et al. Multislice CT. Cham: Springer, 2017: 619-639. DOI: 10.1007/174_2017_22.
[15] Williams EA, Bowman AW. Multimodality imaging of small bowel neoplasms[J]. Abdom Radiol, 2019, 44(6): 2089-2103. DOI: 10.1007/s00261-019-01955-y
[16] El-Menyar A, Mekkodathil A, Al-Thani H. Diagnosis and management of gastrointestinal stromal tumors: an up-to-date literature review[J]. J Cancer Res Ther, 2017, 13(6): 889-900. DOI: 10.4103/0973-1482.177499
[17] Aparicio T, Zaanan A, Mary F, et al. Small bowel adenocarcinoma[J]. Gastroenterol Clin North Am, 2016, 45(3): 447-457. DOI: 10.1016/j.gtc.2016.04.004
[18] Maldonado FJ, Sheedy SP, Iyer VR, et al. Reproducible imaging features of biologically aggressive gastrointestinal stromal tumors of the small bowel[J]. Abdom Radiol, 2018, 43(7): 1567-1574. DOI: 10.1007/s00261-017-1370-6
[19] Li J, Ye YJ, Wang J, et al. Chinese consensus guidelines for diagnosis and management of gastrointestinal stromal tumor[J]. Chin J Cancer Res, 2017, 29(4): 281-293. DOI: 10.21147/j.issn.1000-9604.2017.04.01
[20] 陈允志, 李文武. MSCT影像特征对胃肠道间质瘤危险度的预测价值[J]. 中国辐射卫生,2021,30(4):496-500. DOI: 10.13491/j.issn.1004-714X.2021.04.021
Chen YZ, Li WW. The predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors[J]. Chin J Radiol Health, 2021, 30(4): 496-500. DOI: 10.13491/j.issn.1004-714X.2021.04.021
[21] 顾阳春, 薛海桥. 胃肠道间质瘤CT征象及临床病理学特征分析[J]. 肿瘤影像学,2022,31(3):290-295. DOI: 10.19732/j.cnki.2096-6210.2022.03.012
Gu YC, Xue HQ. CT signs and clinicopathological features of gastrointestinal stromal tumor[J]. Oncoradiology, 2022, 31(3): 290-295. DOI: 10.19732/j.cnki.2096-6210.2022.03.012
[22] Kim SW, Kim HC, Yang DM, et al. Gastrointestinal stromal tumours (GISTs) with a thousand faces: atypical manifestations and causes of misdiagnosis on imaging[J]. Clin Radiol, 2016, 71(2): e130-e142. DOI: 10.1016/j.crad.2015.10.025
[23] Inoue A, Ota S, Sato S, et al. Comparison of characteristic computed tomographic findings of gastrointestinal and non-gastrointestinal stromal tumors in the small intestine[J]. Abdom Radiol, 2019, 44(4): 1237-1245. DOI: 10.1007/s00261-018-1865-9
[24] Shinya T. Malignant small bowel neoplasms: a review of post-contrast multiphasic multidetector computed tomography[J]. J Med Invest, 2022, 69(1.2): 19-24. DOI: 10.2152/jmi.69.19
[25] Basturk O, Yang ZH, Tang LH, et al. The high-grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms[J]. Am J Surg Pathol, 2015, 39(5): 683-690. DOI: 10.1097/PAS.0000000000000408
[26] Kim JS, Park SH, Hansel S, et al. Imaging and screening of cancer of the small bowel[J]. Radiol Clin North Am, 2017, 55(6): 1273-1291. DOI: 10.1016/j.rcl.2017.06.008
[27] Levy AD, Sobin LH. Gastrointestinal carcinoids: imaging features with clinicopathologic comparison[J]. RadioGraphics, 2007, 27(1): 237-257. DOI: 10.1148/rg.271065169
[28] Manguso N, Gangi A, Nissen N, et al. Long-term outcomes after elective versus emergency surgery for small bowel neuroendocrine tumors[J]. Am Surg, 2018, 84(10): 1570-1574. DOI: 10.1177/000313481808401006
[29] Pizzi M, Sabattini E, Parente P, et al. Gastrointestinal lymphoproliferative lesions: a practical diagnostic approach[J]. Pathologica, 2020, 112(3): 227-247. DOI: 10.32074/1591-951X-161
[30] Oka P, Sidhu R. Small bowel lymphoma: clinical update and challenges for the gastroenterologist[J]. Curr Opin Gastroenterol, 2022, 38(3): 270-278. DOI: 10.1097/MOG.0000000000000829
[31] Olszewska-Szopa M, Wróbel T. Gastrointestinal non-Hodgkin lymphomas[J]. Adv Clin Exp Med, 2019, 28(8): 1119-1124. DOI: 10.17219/acem/94068
[32] Thomas AS, Schwartz M, Quigley E. Gastrointestinal lymphoma: the new mimic[J]. BMJ Open Gastroenterol, 2019, 6(1): e000320. DOI: 10.1136/bmjgast-2019-000320
[33] Lewis RB, Mehrotra AK, Rodríguez P, et al. From the radiologic pathology archives: gastrointestinal lymphoma: radiologic and pathologic findings[J]. RadioGraphics, 2014, 34(7): 1934-1953. DOI: 10.1148/rg.347140148
[34] Kohri M, Tsukasaki K, Akuzawa Y, et al. Peripheral T-cell lymphoma with gastrointestinal involvement and indolent T-lymphoproliferative disorders of the gastrointestinal tract[J]. Leuk Res, 2020, 91: 106336. DOI: 10.1016/j.leukres.2020.106336
[35] 魏渭, 林伟, 胡小艳, 等. 原发性肠道淋巴瘤的多层螺旋CT表现[J]. 中国CT和MRI杂志,2022,20(7):158-160. DOI: 10.3969/j.issn.1672-5131.2022.07.053
Wei W, Lin W, Hu XY, et al. The multi-slice CT features of primary intestinal lymphoma[J]. Chin J CT MRI, 2022, 20(7): 158-160. DOI: 10.3969/j.issn.1672-5131.2022.07.053
[36] Horton KM, Fishman EK. Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis[J]. J Comput Assist Tomogr, 2004, 28(1): 106-116. DOI: 10.1097/00004728-200401000-00019
[37] Gelsomino F, Balsano R, De Lorenzo S, et al. Small bowel adenocarcinoma: from molecular insights to clinical management[J]. Curr Oncol, 2022, 29(2): 1223-1236. DOI: 10.3390/curroncol29020104
[38] Benson AB, Venook AP, Al-Hawary MM, et al. Small bowel adenocarcinoma, version 1.2020, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2019, 17(9): 1109-1133. DOI: 10.6004/jnccn.2019.0043
[39] Puccini A, Battaglin F, Lenz HJ. Management of advanced small bowel cancer[J]. Curr Treat Options Oncol, 2018, 19(12): 69. DOI: 10.1007/s11864-018-0592-3
[40] McLaughlin PD, Maher MM. Primary malignant diseases of the small intestine[J]. AJR Am J Roentgenol, 2013, 201(1): W9-W14. DOI: 10.2214/AJR.12.8492
[41] Gore RM, Mehta UK, Berlin JW, et al. Diagnosis and staging of small bowel tumours[J]. Cancer Imaging, 2006, 6(1): 209-212. DOI: 10.1102/1470-7330.2006.0031
[42] Zeh III H. Cancer of the small intestine[M]//DeVita VT Jr, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005: 1035-1048.
[43] Lubner MG, Smith AD, Sandrasegaran K, et al. CT texture analysis: definitions, applications, biologic correlates, and challenges[J]. RadioGraphics, 2017, 37(5): 1483-1503. DOI: 10.1148/rg.2017170056
[44] Feng C, Lu FF, Shen YQ, et al. Tumor heterogeneity in gastrointestinal stromal tumors of the small bowel: volumetric CT texture analysis as a potential biomarker for risk stratification[J]. Cancer Imaging, 2018, 18(1): 46. DOI: 10.1186/s40644-018-0182-4
[45] Liu SL, Zhang CY, Liu RQ, et al. CT texture analysis for preoperative identification of lymphoma from other types of primary small bowel malignancies[J]. Biomed Res Int, 2021, 2021: 5519144. DOI: 10.1155/2021/5519144
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