Gastrointestinal tract focal mass lesions: role of CT and barium evaluations.

Fifty-eight patients with focal mass lesions involving the gastrointestinal tract were studied retrospectively. The diagnostic value of CT scans was seen by assessing the barium studies alone, then by combined review of radiographs and CT scans. Patient management decision making was similarly evaluated. CT scanning aided in diagnosis of the focal masses in 17 patients (29%), changing the differential diagnosis in eight (14%) and increasing diagnostic confidence significantly in nine (16%). In 21 (36%) additional cases, the diagnosis did not change, but CT scanning improved the understanding of disease extent. In the remaining 20 cases (34%), CT scanning did not help diagnostically. CT scanning altered patient management decisions in 19 of the 58 patients (33%). CT study was most helpful in cases of benign extrinsic cystic disease, lymphoma, and smooth-muscle tumors and less helpful for adenocarcinomas of the bowel. The value of the CT data increased as one moved from mucosal lesions to submucosal or extrinsic lesions.