The value of double contrast-enhanced ultrasound and three-dimensional contrast-enhanced ultrasound in differential diagnosis of benign and malignant gastric ulceration

doi:10.3877/cma.j.issn.1672-6448.2015.07.005

Abstract

Abstract:

Objective

To investigate the value of double contrast-enhanced ultrasonography (DCEUS) in combination with three-dimension (3D) contrast-enhanced ultrasound in diagnosis of benign or malignant gastric ulceration.

Methods

A total of 47 patients with gastric lesions were enrolled in this study. All have the pathological results, 22 of them were benign ulceration and 25 were malignant. All patients underwent DCEUS and 3D contrast-enhanced ultrasound. On the basis of oral contrast-enhanced ultrasound agents, intravenous contrast-enhanced ultrasound agents were given at the same time. Images and data were recorded. The arrival time (AT), time to peak (TTP), infusion time (IT), baseline intensity (BI), peak intensity (PI) and enhanced intensity (EI) were calculated using the time-intensity curve (TIC).

Results

All benign ulcerations were imaged as small pits with slight thicken of gastric wall [(8.66±2.87) mm] using DCEUS, while malignant lesions were relatively large irregular-shape, unevenly-bottom pits with significant thicken of gastric wall [(13.98±3.63)~(20.83±3.69) mm]. 3D-DCEUS images were analyzed for gastric mucosal folds, ulceration lesions, as well as local vascularity. All ulceration lesions showed broken of gastric mucosal folds, and malignant lesion showed thickness of gastric wall as "crater" , with rich and irregular vascularity. There were no statistical differences between benign gastric ulcerations and adjacent normal gastric wall (P>0.05). Malignant gastric ulceration were compared with adjacent normal gastric wall tissue, TTP, IT and BI had no statistical differences (P>0.05), while AT, PI, and EI had statistical differences [(9.00±2.02) s vs (10.90±2.75) s, P=0.008], [(35.46±5.77) dB vs (29.73±8.72) dB, P=0.009] and [(30.76±5.76) dB vs (23.45±6.84) dB, P=0.000]. PI and EI in malignant tumors were higher than those in benign ones (P<0.05).

Conclusions

DCEUS could be a new method in differentiating benign and malignant gastric ulceration, which can get both the anatomy and perfusion information of gastric wall as well as lesions. 3D-DCEUS can improve the quality of the conventional ultrasound image.

Key words: Ultrasonography, Microbubbles, Rectal gastrointestinal stromal tumors

Xiuhua Yu, Hong Shi, Hong Zhang, Zixiang Kong, Bin Qian, Zhangrui Wei, Li Li, Xinzhang Guo. The value of double contrast-enhanced ultrasound and three-dimensional contrast-enhanced ultrasound in differential diagnosis of benign and malignant gastric ulceration[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(07): 519-525.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2015.07.005

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Figures/Tables 9

References 14

1	陆再英, 钟南山. 内科学[M]. 7版. 北京: 人民卫生出版社, 2008: 381-387.
2	李益农, 陆星华. 消化内镜学[M]. 2版. 北京: 科技出版社, 1996: 252-266.
3	施红, 蒋天安. 实用超声造影诊断学[M]. 北京: 人民军医出版社, 2013: 305-334.
4	Nakajima Y, Gotanda T, Uchimiya H, et al. Inhibition of metastasis of tumor cells overexpressing thymidine phosphorylase by 2-deoxy-L-ribose[J]. Cancer Res, 2004, 64(5): 1794-1801.
5	陈光阳，夏国园，郭心璋. 胃壁隆起增厚性病变的声像图诊断分析[J]. 实用医学杂志, 2007, 23(23): 3725-3727.
6	Folkman J. Tumor angiogenesis: therapeutic implications[J]. N Engl J Med, 1971, 285(21): 1182-1186.
7	贾守强，王锦玲，谢炳坤, 等. 1.5T磁共振动态增强成像参数评估进展期胃癌肿瘤血管生成的临床研究[J]. 临床放射学杂志, 2013, 32(7): 968-971.
8	黄品同，杨勇明，张海平, 等. 胃癌超声双重造影增强强度与微血管密度的相关性研究[J]. 中国超声医学杂志, 2008, 24(3): 257-259.
9	Huang P, Li S, Wilbert S, et al. Double contrast-enhanced ultrasonography evaluation of preoperative Lauren classification of advanced gastric[J]. Arch Med Sci, 2011, 7(2): 287-293.
10	张宏，施红，卫张蕊, 等. 实时三维经食道超声心动图在成人房间隔缺损介入封堵术中的应用[J]. 中国介入影像与治疗学, 2013, 10(5): 294-298.
11	毛丽娟，王文平，丁红, 等. 肝肿瘤动态三维超声造影与二维超声造影的比较研究[J]. 中华超声影像学杂志, 2012, 21(2): 133-137.
12	余秀华，施红，钱斌, 等. 超声造影对宫颈癌血管生成的初步研究[J/CD]. 中华医学超声杂志:电子版, 2010, 7(7): 1176-1186.
13	郭俊，王莎莎，程琦, 等. 经阴道实时三维子宫输卵管超声造影剂逆流分析[J]. 中国医学影像技术, 2014, 30(7): 1063-1066.
14	Shi H, Yu XH, Guo XZ, et al. Double contrast-enhanced two-dimensional and three-dimensional ultrasonography for evaluation of gastric lesions[J]. World J Gastroenterol, 2012, 18(31): 4136-4144.

组别	例数	AT（s）	TTP（s）	IT（s）	BI（dB）	PI（dB）	EI（dB）
良性胃溃疡组	22	9.58±2.35	16.54±3.87	7.00±2.59	5.60±3.22	30.64±7.83	24.59±8.47
周围正常胃壁组织	22	9.48±2.42	17.21±4.36	7.73±3.08	6.05±3.95	32.03±8.18	25.98±8.51
t值	?	0.145	-0.538	-0.845	-0.417	-0.575	-0.543
P值	?	0.886	0.593	0.403	0.679	0.268	0.590

组别	例数	AT（s）	TTP（s）	IT（s）	BI（dB）	PI（dB）	EI（dB）
良性胃溃疡组	22	9.58±2.35	16.54±3.87	7.00±2.59	5.60±3.22	30.64±7.83	24.59±8.47
周围正常胃壁组织	22	9.48±2.42	17.21±4.36	7.73±3.08	6.05±3.95	32.03±8.18	25.98±8.51
t值	?	0.145	-0.538	-0.845	-0.417	-0.575	-0.543
P值	?	0.886	0.593	0.403	0.679	0.268	0.590

组别	例数	AT（s）	TTP（s）	IT（s）	BI（dB）	PI（dB）	EI（dB）
溃疡型胃癌组	25	9.00±2.02	16.52±3.78	7.53±2.44	4.58±3.22	35.46±5.77	30.76±5.76
周围正常胃壁组织	25	10.90±2.75	19.64±4.82	8.78±4.74	6.69±5.08	29.73±8.72	23.45±6.84
t值	?	-2.786	-0.538	-1.178	-1.750	2.741	4.091
P值	?	0.008	0.593	0.244	0.087	0.009	0.000

组别	例数	AT（s）	TTP（s）	IT（s）	BI（dB）	PI（dB）	EI（dB）
溃疡型胃癌组	25	9.00±2.02	16.52±3.78	7.53±2.44	4.58±3.22	35.46±5.77	30.76±5.76
周围正常胃壁组织	25	10.90±2.75	19.64±4.82	8.78±4.74	6.69±5.08	29.73±8.72	23.45±6.84
t值	?	-2.786	-0.538	-1.178	-1.750	2.741	4.091
P值	?	0.008	0.593	0.244	0.087	0.009	0.000

相关参数	准确率	敏感度	特异度	阳性预测值	阴性预测值
PI≥39.04 dB	66.0（31/47）	40.0（10/25）	95.5（21/22）	90.9（10/11）	58.3（21/36）
EI≥31.42 dB	63.8（30/47）	48.0（12/25）	81.8（18/22）	75.0（12/16）	58.1（18/31）
PI与EI联合	72.0（34/47）	64.0（16/25）	95.5（21/22）	92.9（13/14）	56.8（21/37）

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