The role of i.v. and oral contrast enhanced ultrasonography in the characterization of gastric tumors. A preliminary study

Abstract

Objective: To identify the diagnosis benefits of harmonics optimized i.v. contrast enhanced ultrasonography (CEUS) in the detection and characterization of several gastric neoplasms.

Material and method: The study group included 10 patients with gastric neoplasms, either epithelial or stromal. The examination included grey scale ultrasonography combined with hydrosonography and harmonics ultrasonography with i.v. contrast media, centered on the tumor, using the surrounding normal gastric wall as witness. All cases were examined by endoscopy, followed by a pathology report and eight of the patients underwent surgery. CEUS followed the dynamics of the contrast media during the arterial (up to 30 seconds since administration) and venous (30 to 60 seconds since administration) phases. The characteristics of contrast uptake in the region of interest were also studied.

Results: In gastric tumors an non-homogeneous uptake was registered during the arterial phase followed by contrast wash-out during the venous phase. In stromal tumors (GIST) there was an accelerated and uniform uptake in the arterial phase, while the wash-out was delayed. CEUS was able to show the masses in all cases. The aspect of the lesions on the grey scale images - infiltration of polyp - consolidated the diagnosis.

Conclusions: The analysis of the cases included in the study proved that CEUS represents a promising method in the characterization of infiltrative and proliferative gastric tumors. The information must be combined with those obtained from the 2D harmonics ultrasound exam. Extended studies, on a higher number of cases, are necessary in order to demonstrate the practical use of the method.