Diagnosis of gastrointestinal wall diffuse hemangioma by CT: A report of 4 cases

Objective To improve the understanding of gastrointestinal wall diffuse hemangioma (GWDH)by summarizing its CT features. Methods Clinical data and imaging features of 4 GWDH patients admitted to our hospital from April to November 2012 were retrospectively analyzed.Of the 4 patients, 3 underwent routine abdominal plain and enhanced CT scanning, 1 underwent pelvis plain and enhanced CT scanning due to bleeding in the lower digestive tract. Results The average age of the 4 patient was 16, 30, 42 and 33 years old, respectively.The 3 male patients had presented with repeated painless bloody stools since their childhood and the female patient had bloody stools for more than 1 month.CT showed that the lesions involving gastric wall and several segments of intestinal wall were manifested as circularly and irregularly thickened long segment wall with local lumen stricture and multiple punctuate and nodular calcif ication shadows.Enhanced CT showed no signif icant change in the lesions at conventional arterial and venous phases but at the delayed 90-120 s phase.The lesions showed progressive enhancement with their CT value increased to 20-30 HU.Moderate homogenous enhancement of the lesions was observed in 1 patient 50 min after delayed scanning with the CT value of about 60 HU.A portal venin drainage tube was placed in 3 patients and a tortuous subcutaneous vein drainage tube was placed in 1 patient.No normal structure of the portal vein was observed in 2 patients, indicating that sponge-like degeneration occurs in the portal vein. Conclusion Attention should be paid to GWGH in those who have presented with bloody stools or repeated bloody stools since their childhood.Specif ic CT features in combination with clinical history contribute to the correct diagnosis of bloody stools.