Meng-jia LIU, Wei-gen ZENG, Yong WANG, Xuan-tong GONG, Jie HAN, Bo WANG, Ning-yi CUI. Manifestations of Rectal Stromal Tumor in the Endorectal Ultrasonography and Contrast-enhanced Ultrasonography[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(1): 27-33. doi: 10.3969/j.issn.1674-9081.20190223
Citation:
Meng-jia LIU, Wei-gen ZENG, Yong WANG, Xuan-tong GONG, Jie HAN, Bo WANG, Ning-yi CUI. Manifestations of Rectal Stromal Tumor in the Endorectal Ultrasonography and Contrast-enhanced Ultrasonography[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(1): 27-33. doi: 10.3969/j.issn.1674-9081.20190223
Meng-jia LIU, Wei-gen ZENG, Yong WANG, Xuan-tong GONG, Jie HAN, Bo WANG, Ning-yi CUI. Manifestations of Rectal Stromal Tumor in the Endorectal Ultrasonography and Contrast-enhanced Ultrasonography[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(1): 27-33. doi: 10.3969/j.issn.1674-9081.20190223
Citation:
Meng-jia LIU, Wei-gen ZENG, Yong WANG, Xuan-tong GONG, Jie HAN, Bo WANG, Ning-yi CUI. Manifestations of Rectal Stromal Tumor in the Endorectal Ultrasonography and Contrast-enhanced Ultrasonography[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(1): 27-33. doi: 10.3969/j.issn.1674-9081.20190223
Objective To analyze the features of rectal stromal tumors in the endorectal ultrasonography and contrast enhanced ultrasonography (CEUS).Methods The clinical data of patients with rectal stromal tumors who were admitted in the Cancer Hospital, Chinese Academy of Medical Sciences from February 2013 to February 2019 were analyzed retrospectively, including clinical manifestations, CT, MRI, colonoscopy, rectalendorectal ultrasound, and CEUS. According to the consensus on the classification system of National Institutes of Health (NIH), the patients were divided into high-risk, intermediate-risk, low and very low-risk groups. The imaging features of different groups were compared to each other, and the accuracy of different examination methods in the diagnosis of rectal stromal tumors were analyzed.Results A total of 12 patients were included:8 males and 4 females with a median age of 54.0(50.5, 65.25)years. There were 6 cases in very low/low-risk group and 6 cases in intermediate/high-risk group. All of the tumors showed an extroluminal growth pattern, 58.3%(7/12) appearing as oval-shaped, 41.7%(5/12) as lobulated, 91.7%(11/12) with distinct borders, 91.7%(11/12) with heterogeneous echogenicity, 41.7%(5/12) of large tumors with cystic regions, and 91.7%(11/12) with abundant internal blood flow signals. The enhancing mode showed hyper-enhanced with a "fast in and slow out" pattern; the average rise time was (8.10±4.03)s; the average time to peak was (25.54±12.16)s. A total of 5 (83.3%) patients in the intermediate/high-risk group showed inhomogeneous enhancement, centripetal enhancement, perfusion defects. Only one (16.7%) patient in the very low/low-risk group showed similar CEUS feature, and all 6 (100%) patients showed diffuse enhancement. The ratio of correct diagnosis was 60.0% in CT, 66.7% in MRI, 0 in colonoscopy, and 100% in rectal endorectal ultrasound combined with CEUS.Conclusion s The combination of endorectal ultrasonography and CEUS with coupling gel filling the rectum could clearly show the original layer and distribution pattern of rectal stromal tumors, which is helpful for the diagnosis of rectal stromal tumor and accurate risk stratification of the rectal stromal tumor.
Tanaka S, Oka S, Kaneko I, et al. Endoscopic submucosal dissection forcolorectal neoplasia:possibility of standardiza-tion[J]. Gastrointest Endosc, 2007, 66:100-107. doi: 10.1016/j.gie.2007.02.032
[2]
Ma GL, Murphy JD, Martinez ME, et al. Epidemiology of gastrointestinal stromal tumors in the era of histology codes:results of a population-based study[J]. Cancer Epidemiol Biomarkers Prev, 2015, 24:298-302 doi: 10.1158/1055-9965.EPI-14-1002
[3]
Tran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestina1 stromal tumors:an analysis of 1458 cases from 1992 to 2000[J]. Am J Gastroenterol, 2005, 100:162-168 doi: 10.1111/j.1572-0241.2005.40709.x
Joensuu H. Risk stratification of patients diagnosed with gastrointestinalstromal tumor[J]. Hum Pathol, 2008, 39:1411-1419. doi: 10.1016/j.humpath.2008.06.025
[7]
Zambo I, Veselý K. WHO classification of tumours of soft tissue and bone 2013:the main changes compared to the 3rd edition] [J]. Cesk Patol, 2014, 50:64-70.
Sidhu PS, Cantisani V, Dietrich CF, et al. The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications:Update 2017(Long Version)[J]. Ultraschall Med, 2018, 39:e2-e44. doi: 10.1055/a-0586-1107
[10]
Wang Y, Zhou CW, Hao YZ, et al. Improvement in T-staging of rectal carcinoma:using a novel endorectal ultrasonography technique with sterile coupling gel filling the rectum[J]. Ultrasound Med Biol, 2012, 38:574-579. doi: 10.1016/j.ultrasmedbio.2011.12.020
[11]
Wang Y, Li L, Wang YX, et al. Time-intensity curve parameters in rectal cancer measured using endorectal ultrasonography with sterile coupling gels filling the rectum:correlations with tumor angiogenesis and clinicopathological features[J]. Biomed Res Int, 2014, 2014:587806.
Li J, Ye Y, Wang J, et al. Chineseconsensus guidelines for diagnosis and management of gastrointestinal stromal tumor[J]. Chin J Cancer Res, 2017, 29:281-293. doi: 10.21147/j.issn.1000-9604.2017.04.01