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- Title
Differential diagnosis of gastric cancer and gastritis: the role of contrast-enhanced ultrasound (CEUS).
- Authors
Xue, Heng; Ge, Hui-yu; Miao, Li-ying; Wang, Shu-min; Zhao, Bo; Wang, Jin-rui; Cui, Li-gang
- Abstract
Objectives: To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in differential diagnosis of gastric cancer and gastritis, with histological results as reference standard. Methods: From September 2011 to August 2014, 82 patients (50 males and 32 females; mean age ± SD, 59.5 ± 15.0 years; range 19-91 years) with gastric cancer or gastritis were included in this Ethics Committee-approved prospective study. Conventional ultrasonography (US) and CEUS were applied to distinguish the two lesions, and both qualitative and quantitative features were evaluated. Results: Of the 82 histopathologic-proven lesions, 58 were cancer and 24 were gastritis. For US, the gastric wall stratification was not preserved in about one-third of cancer (21/58, 36.2%) compared with gastritis (0/24, 0%) ( p < 0.001). Blurred, angular, or spiculated serosa margin and increased echogenicity in perigastric fat appeared only in cancer (10/58, 17.2%), and all of them proved to be pathologic T3 or T4 stage. On CEUS, gastric cancer usually manifested as diffused enhancement without comb-teeth-like vessels (parallel curvilinear structures representing arterial branching within the gastric wall) (56/58, 96.6%), while these vessels presented in most gastritis (19/24, 79.2%, p < 0.001). For quantitative analysis, the malignant lesions showed later and lower enhancement ( p < 0.001), and they also had slower speed to reach the peak intensity ( p < 0.001). On CEUS, the absence of comb-teeth-like vessel is most reliable for diagnosing malignancy, and the sensitivity, specificity, and accuracy were 96.5%, 79.2%, and 91.5%, respectively. Conclusions: Our results demonstrated the usefulness and accuracy of US and CEUS in differential diagnosis of gastric cancer and gastritis. CEUS has the potential to make the diagnosis more accurate.
- Subjects
CONTRAST-enhanced ultrasound; GASTRITIS; ULTRASONIC imaging; LINE integrals; CANCER diagnosis; THERAPEUTICS
- Publication
Abdominal Radiology, 2017, Vol 42, Issue 3, p802
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-016-0952-z