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GIÁ TRỊ CẮT LỚP VI TÍNH TRONG CHẨN ĐOÁN PHÂN BIỆT CÁCU NGUYÊN PHÁTTHƯỜNG GẶP Ở RUỘT NON
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Abstract
SUMMARY
Objectives: The purpose of the this study was to analyze imaging roles to assessthe diagnostic capacity for differentiating the common
primary small bowel tumors.
Methods: We performed a retrospective study from the medical database from January 2015 to May 2018 at University medical center and Cho Ray hospital. The inclusion criteria were as follows: pathologically proven primary small bowel neoplasms andpatients were performed MDCT with intravenous contrast media. Radiologist were blinded to the pathological information, reviewed the image findings according to the data collection paper. Radiologist collects the characteristics of neoplasm such as anatomical distribution, growth, enhancement, wall thickening patterns, size, hyperplasia vascular on tumor surfaces and lymph node characteristics. Then, comparing each
findings to pathology report to access specificity, sensitivity and positive predictive value (PPV) of them.
Results: A total of 98 patients met the criteria for analysis in thepresent retrospective study, 31 adenocarcinomas, 22 lymphomas, 30 GISTs anf 15 others. The extramural growth pattern isreliable prediction of GIST, with PPV of 82.3%. All of GISTs show moderate to avid enhancement. Tumor density of greater than or equal to 110 HU is likely to be GIST, with PPV of84.9%. Proliferation of blood vessels on tumor surfaces can help discriminate GIST from the others, with PPV of92%. Bowel wall thickening is the common patternof adenocarcinoma and lymphoma. Apple-core-like, shoulder defect
and focal involvement are probably findings of adenocarcinoma, with PPV of 81.8%, 71.4% and 76.9%, respectively. Aneurysmal dilatation of the
lumen and marked thickening wall bowel equal or greater than 25mm can strongly suggest lymphoma, with PPV of 87.5% and 72.7%, respectively. Enlarged lymph node with shorter axis greater than 20mmor multiple lymph nodes fused together forming a bulky massare likely to be lymphoma, with specificity of 100%.
Conclusion: MDCT findings could potentially be useful to differentiate the common primary small bowel neoplasms based on analyzing specific imaging characteristics of each tumor after classifying by growth pattern lesion.
Article Details
Keywords
Small bowel neoplasm, differentiate
References
1. Anzidei M., Napoli A., et al. (2011), “Malignant tumours of the small intestine: a review of histopathology, multidetector CT and MRI aspects”.Br J Radiol, 84 (1004), pp. 677-690.
2. Buckley J A, Fishman E K (1998), “CT evaluation of small bowel neoplasms: spectrum of disease”.RadioGraphics, 18 (2), pp. 379-392.
3. Byun J. H., Ha H. K., et al. (2003), “CT findings in peripheral T-cell lymphoma involving the gastrointestinal tract”.Radiology, 227 (1), pp. 59-67.
4. Chang S. T., Menias C. O. (2013), “Imaging of primary gastrointestinal lymphoma”.Semin Ultrasound CT MR, 34 (6), pp. 558-65.
5. Farhat M. H., Shamseddine A. I., et al. (2008), “Small bowel tumors: clinical presentation, prognosis, and outcome in 33 patients in a tertiary care center”.J Oncol, 2008, pp. 212067.
6. Fernandes D. D., Galwa R. P., et al. (2012), “Cross-sectional imaging of small bowel malignancies”.Can Assoc Radiol J, 63 (3), pp. 215-21.
7. Fernandes T., Oliveira M. I., et al. (2014), “Bowel wall thickening at CT: simplifying the diagnosis”.Insights Imaging, 5 (2), pp. 195-208.
8. Ganeshan Dhakshina, Bhosale Priya, et al. (2013), “Imaging Features of Carcinoid Tumors of the Gastrointestinal Tract”.American Journal of Roentgenology, 201 (4), pp. 773-786.
9. Ghai Sangeet, Pattison John, et al. (2007), “Primary Gastrointestinal Lymphoma: Spectrum of Imaging Findings
with Pathologic Correlation”.RadioGraphics, 27 (5), pp. 1371-1388.
10. Gollub Marc J. (2008), “Imaging of Gastrointestinal Lymphoma”.Radiologic Clinics, 46 (2), pp. 287-312.
11. Gore Richard M., Mehta Uday K., et al. (2006), “Diagnosis and staging of small bowel tumours”.Cancer Imaging, 6 (1), pp. 209-212.
12. Horwitz Benjamin M., Zamora G. Elizabeth, et al. (2011), “Best Cases from the AFIP: Gastrointestinal Stromal Tumor of the Small Bowel”.RadioGraphics, 31 (2), pp. 429-434.
13. Hou Y. Y., Tan Y. S., et al. (2004), “C-kit gene mutation in human gastrointestinal stromal tumors”.World J Gastroenterol, 10 (9), pp. 1310-1314.
14. James S., Balfe D. M., et al. (1987), “Small-bowel disease: categorization by CT examination”.American Journal of Roentgenology, 148 (5), pp. 863-868.
15. Lê Văn Cường (2011), “Giải phẫu sau đại học”,
16. Levy A. D., Remotti H. E., et al. (2003), “Gastrointestinal stromal tumors: radiologic features with pathologic correlation”.Radiographics, 23 (2), pp. 283-304, 456; quiz 532.
17. Levy A. D., Sobin L. H. (2007), “From the archives of the AFIP: Gastrointestinal carcinoids: imaging features with clinicopathologic comparison”.Radiographics, 27 (1), pp. 237-57.
18. Lo Re Giuseppe, Federica Vernuccio, et al. (2015), “Radiological features of gastrointestinal lymphoma”.
Gastroenterology research and practice, 2016.
19. Macari Michael, Megibow Alec J., et al. (2007), “A Pattern Approach to the Abnormal Small Bowel: Observations
at MDCT and CT Enterography”.American Journal of Roentgenology, 188 (5), pp. 1344-1355.
20. Masselli G., Colaiacomo M. C., et al. (2012), “MRI of the small-bowel: how to differentiate primary neoplasms and mimickers”.The British Journal of Radiology, 85 (1014), pp. 824-837.
21. Masselli Gabriele (2013), “Small Bowel Imaging: Clinical Applications of the Different Imaging Modalities—A
Comprehensive Review”.ISRN Pathology, 2013, pp. 1-13.
22. McLaughlin Patrick D., Maher Michael M. (2013), “Primary Malignant Diseases of the Small Intestine”.American Journal of Roentgenology, 201 (1), pp. W9-W14.
23. Neugut A. I., Jacobson J. S., et al. (1998), “The epidemiology of cancer of the small bowel”.Cancer Epidemiol Biomarkers Prev, 7 (3), pp. 243-251.
24. Nguyễn Quang Quyền (2011), “Bài giảng Giải phẫu học”, pp. tr. .
25. Pan Sai Yi, Morrison Howard (2011), “Epidemiology of cancer of the small intestine”.World Journal of Gastrointestinal Oncology, 3 (3), pp. 33-42.
26. Sailer Johannes, Zacherl Johannes, et al. (2007), “MDCT of small bowel tumours”.Cancer Imaging, 7 (1), pp. 224-233.
27. Sandrasegaran Kumaresan, Rajesh Arumugam, et al. (2005), “Gastrointestinal Stromal Tumors: Clinical, Radiologic, and Pathologic Features”.American Journal of Roentgenology, 184 (3), pp. 803-811.
28. Scarsbrook Andrew F., Ganeshan Arul, et al. (2007), “Anatomic and Functional Imaging of Metastatic Carcinoid Tumors”.RadioGraphics, 27 (2), pp. 455-477.
29. Shinya T., Inai R., et al. (2017), “Small bowel neoplasms: enhancement patterns and differentiation using postcontrast
multiphasic multidetector CT”.Abdom Radiol (NY), 42 (3), pp. 794-801.
30. Shirsat H. S., Vaiphei K. (2014), “Primary gastrointestinal lymphomas - A study of 81 Cases from a Tertiary Healthcare Centre”.Indian J Cancer, 51 (3), pp. 290-292.
31. Tzen C. Y., Mau B. L. (2005), “Analysis of CD117-negative gastrointestinal stromal tumors”.World J Gastroenterol, 11 (7), pp. 1052-1055.
32. Vasconcelos R. N., Dolan S. G., et al. (2017), “Impact of CT enterography on the diagnosis of small bowel gastrointestinal stromal tumors”.Abdom Radiol (NY), 42 (5), pp. 1365-1373.