Preoperative Gross Classification Of Gastric Adenocarcinoma:Comparison Of Double Contrast-Enhanced Ultrasound And Multi-detector Row CT

ObjectiveTo compare the accuracy of double contrast-enhanced ultrasound(DCEUS)and multi-detector row CT(MDCT)in determining the gross classification in patients with gastric carcinoma(GC)preoperatively.Methods239 patients with GC proved by endoscopic biopsy were included.DCEUS(intravenous microbubbles combined with oral contrast-enhanced ultrasound)and MDCT were performed preoperatively.The diagnostic accuracy of DCEUS and MDCT in determining gross classification was calculated and compared.ResultsThe overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT(84.9%vs79.9%,p<0.001);The accuracy of DCEUS indetermining EGC,Borrmann ?,?,?,and ? was 66.7%,87.1%,86.5%,87.1%and 91.2%;The accuracy of MDCT in determining EGC,Borrmann ?,?,?,and IV was 56.7%?83.9%?79.7%?80.0%?97.1%;There was no significant difference in accuracy between DCEUS and MDCT for Borrmann ? and ? classification of AGC(?2=1.175?p=0.323 for type ?;?2=2.171?p=0.141 for type ?);The accuracy of DCEUS for EGC?Bomann ? and ? classification of GC was higher than that of MDCT(?2=16.307?p= 0.000 for EGC;?2=39.950?p= 0.000 for type ?;?2=35.770?p= 0·000 for type ?).Intra-and inter-observe reproducibility were both almost perfect for assessing the gross appearance of GC with a Kappa value of 0.816(p=0.000)for intra-observer and 0.759(p=0.000)for inter-observer by DCEUS.The intra-and inter-observe reproducibility were also both almost perfect for assessing the gross appearance of GC with a Kappa value of 0.833(p=0.000)for intra-observer and 0.832(p=0.000)for inter-observer by MDCT.Conclusion1.The overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT;2.There was no significant difference in accuracy between DCEUS and MDCT for Bomann ? and ? classification of AGC;3.The accuracy of DCEUS in determining the EGC?Borrmann ? and ?classification of GC was higher than that of MDCT;4.The intra-and inter-observe reproducibility of DCEUS and MDCT were both almost perfect for assessing the gross appearance of GC;5.DCEUS may be regarded as a valuable complementary tool to MDCT in determining gross appearance of gastric adenocarcinoma preoperatively.