Oral Contrast-Enhanced Gastric Ultrasonography in the Assessment of Gastric Lesions: A Large-Scale Multicenter Study

Authors

  • Xiao-Zhi Zheng PhD,

    1. Department of Ultrasound, The First People's Hospital of Yancheng, Yancheng, P.R. China
    2. Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, P.R. China
    3. Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, P.R. China
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  • Li-Juan Zhang BS,

    Corresponding author
    1. Department of Ultrasound, Pukou Hospital (The Fourth Affiliated Hospital with Nanjing Medical University), Nanjing, P.R. China
    • Address correspondence to Li-Juan Zhang, Department of Ultrasound, Pukou Hospital (The Fourth Affiliated Hospital with Nanjing Medical University), 18 Puyuan Road, Pukou District, Nanjing 210031, Jiangsu Province, P.R. China. E-mail: zhanglijuanzxz@163.com

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  • Xin-Ping Wu BS,

    1. Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, P.R. China
    2. Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, P.R. China
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  • Wen-Ming Lu BS,

    1. Department of Ultrasound, The First People's Hospital of Huzhou, Huzhou, P.R. China
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  • Jing Wu BS,

    1. Department of Ultrasound, The First People's Hospital of Yancheng, Yancheng, P.R. China
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  • Xu-Yan Tan MS

    1. Department of Ultrasound, Jiangsu Province Tumor Hospital, Nanjing, P.R. China
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  • The authors gratefully acknowledge the technical assistance and helpful discussion of Li-Zhu Miao, You Zhou, Xiao Wang, Wen-Yan Zhou, Xiao-Qin Huang from the Department of Ultrasound, The First People's Hospital of Yancheng.

    The study was performed at the following institutions: The First People's Hospital of Yancheng, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, The Fourth Affiliated Hospital with Nanjing Medical University (Pukou Hospital), The First People's Hospital of Huzhou and Jiangsu Province Tumor Hospital, Jiangsu Province, P.R. China.

Abstract

Objective

To determine the diagnostic efficiency of oral contrast-enhanced gastric ultrasonography in the evaluation of gastric lesions, based on large-scale multicenter study.

Methods

The study enrolled 383,945 patients with suspect gastric lesions who underwent complete oral contrast-enhanced gastric ultrasonography and endoscopic evaluation. Two operators, unaware of the results of other diagnostic procedures, performed each examination independently. The accuracies of conventional ultrasonography, oral contrast-enhanced gastric ultrasonography, and upper gastrointestinal endoscopy were determined.

Results

After oral contrast, the anatomy of the stomach and morphologic features of gastric lesions were clearly visualized. The sensitivities, specificities, positive predictive values, negative predictive values and accuracies of oral contrast-enhanced ultrasonography in detecting the sites, sizes, numbers, and the extent of gastric lesions, were similar to those of upper gastrointestinal endoscopy (P > .05) and far greater than those of conventional ultrasonography (P < .01). Moreover, oral contrast-enhanced ultrasonography was far better than upper gastrointestinal endoscopy (P < .01) and was better than conventional ultrasonography (P < .05) in detecting the submucosal abnormalities (<5mm) and the adjacent structures abnormalities identified in surgical pathology. However, oral contrast-enhanced ultrasonography was a bit poorer than upper gastrointestinal endoscopy (P < .05) and far better than conventional ultrasonography (P < .01) in detecting the minor mucosal abnormalities (<5mm).

Conclusions

Oral contrast-enhanced gastric ultrasonography is superior to conventional gastric ultrasonography in defining the anatomic location and extension of gastric lesions. Its diagnostic performance is not worse than upper gastrointestinal endoscopy and it can be used as a useful supplement to upper gastrointestinal endoscopy.

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