Aims: Gastrointestinal stromal tumours (GIST) show a distinct appearance in imaging methods
such as computed tomography and sonography. In computed tomography it is reported
that necrosis, bleeding and cystic degeneration appears predominantly in larger lesions.
Modern contrast enhanced ultrasound (CEUS) techniques reveal high spatial resolution
as well as real time imaging. However, there are few reports in the literature about
the use of CEUS in the imaging of GIST of the upper gastrointestinal tract.
Methods: 12 patients with GIST of the stomach or the small bowel. Contrast enhanced ultrasound
with 2.4ml BR1 (Bracco, Italy), Acuson Sequoia (Siemens, Erlangen), real time imaging
up to 4 minutes after injection. We describe the features of the lesions in dependency
of their size
Results: In all cases the investigation was technically feasible. All lesions showed a strong
enhancement after injection of the contrast agent beginning at the periphery of the
lesions. In contrast to published data small or large avascular areas, e.g. caused
by necrosis or bleeding could be displayed even in lesions smaller than 3cm.
Conclusions: Using high spatial resolution contrast techniques the demarcation of avascular areas
is a typical sign of GIST tumours of the upper gastrointestinal tract even in small
tumours. This sign should be suggestive for this entity.
