Computed tomography features of gastric leiomyoma versus gastric stromal tumor: a case–control study with propensity score matching

OBJECTIVE: To differentiate gastric leiomyomas (GLs) and gastric stromal tumors (GSTs) based on preoperative enhanced computed tomography characteristics. METHODS: Twenty-six pathologically confirmed GLs were propensity score-matched to 26 GSTs in a 1:1 ratio based on sex, age, tumor site, and tumor size. Tumor shape and contour, mucosal ulceration, growth pattern, enhancement pattern and degree, longest diameter, and longest diameter/vertical diameter ratio were compared between the groups. Hemorrhage, calcification, peripheral invasion, and distant metastasis were also included in the regression analysis for differentiation of the two tumors. RESULTS: Mucosal ulceration was significantly more frequent in GSTs than GLs. The enhancement degree of GSTs was significantly higher than that of GLs in the arterial and portal venous phases. Using enhancement degrees of 18 HU and 23 HU in the arterial phase and venous phase as cutoff values, respectively, we found that an enhancement degree of <18 HU in the arterial phase was an independent influential factor for diagnosis of GLs. No significant differences were found in other morphological characteristics. GLs did not metastasize or invade adjacent tissues. CONCLUSION: A low enhancement degree in GLs is the most valuable quantitative feature for differentiating these two similar tumors.