Study Of Oral Contrast Ultrasonography And Color Doppler Flow Imaging In Diagnosing Gastric Lesions

Objective:To evaluate clinical value of oral contrast ultrasonography and color Doppler flow imaging in diagnosing gastric lesions.Method:54 patients with gastric lesions (confirmed by operation or pathology) and 20 normal control were included.They all underwent transabdominal oral contrast ultrasonography with Gastro Win - 85(Hu Qingyu Pharmaceutical Workshop limited company, Hanzhou) and by a 3.5-5 MHz convex array transducer or a 7.5-12 MHz liner array transducer (Philips iU 22, Netherlands).The appearance of stomach,the wall thickness ,and stomach peristalsis rate were recorded.The lessions were observed carefully,and the number,location,appearance were obtained.Result:1.a total of 54 patients were examined,36 of 54 were diagnosed as gastric carcinoma by contrast ultrasonography and were conformed by operation or pathology, 8 of 54 were diagnosed as gastric ulcer and were conformed by operation or pathology, and 3 gastric stromal tumor,1 gastric malignant lymphoma and 1 lower esophageal cancer were diagnosed.While 3 gastric ulcers were diagnosed as carcinoma and no lessions were observed by US in 2 patients with gastric ulcer. The accuracy of gastric contrast ultrasonography was 90.7% in total.3.Compared with pathologic diagnosis as gold standard the sensitivity, specificity,positive predictive value,negative predictive value of gastric carcinoma with gastric contrast ultrasonography were 100%, 83.3%, 92.3%, 100%, respectively.And the sensitivity, specificity,positive predictive value,negative predictive value of gastric ulcer with this method were 61.5%,100%,100%,89.1%.4.Color Doppler flow signals were scored as 0～I in 11 of 13 benign lessions (84.6%) and as II～III in 24of 41 malignant lessions (58.5%).The difference between two groups was significant (P<0.01).4. 12 patients with early stage of gastric carcinoma and 27 advanced gastric carcinomas were diagnosed by oral contrast ultrasonography and color Doppler flow imaging. The sensitivity and specificity of early stage of gastric carcinoma, advanced gastric carcinoma were 80% ,86.4% , 86.4%,80%,respectively.The resistivity index (RI) of early stage of gastric carcinoma and advanced gastric carcinoma were 0.531±0104, 0.647±0.092, respectively.There was significant difference between the two (p<0.05) .5.The staging accuracy of transabdominal oral contrast ultrasonography and CDFI was 70.0%, 50.0%, 76.5% andl00% in T1, T2, T3 and T4 carcinomas, respectively. The overall accuracy was 72.2%. Overstaging rate in T1, T2, T3 and T4 carcinomas was 30.0%, 37.5%, 8.1%, O,respectively.Understaging rate in T1, T2, T3 and T4 carcinomas was 0,12.5%,15.4%,0.Conclusion:1. Oral contrast ultrasonography is a simple, cheap , atraumatic , nonradioactive method for diagnosing gastric lesions. There was no statistical significance in diagnose accordance rate of oral contrast ultrasonography and gastroscopy. Oral contrast ultrasonography could be another method to diagnoses gastric lesions besides gastroscopy and barium meal examination.2.The sensitivity of diagnosing gastric carcinoma with gastricoral contrast ultrasonography and CDFI is high,especially in detecting metastasis.Its specificity of diagnosing benign ulcer is high,but the misdiagnosis rate and omission diagnose rate is high too.3.Oral contrast ultrasonography and CDFI could evaluate the depth and width of gastric carcinoma infiltrating the stomach wall and detect metastasis.It could play a role in preoperative evaluation, modus operandi selection and prognosis evaluation.4.Oral contrast ultrasonography and CDFI is helpful in differentiating between benign and malignant gastric lessions and play a role in assessment of gastric carcinoma pathogenesis progression.