Improvement to ultrasonographical differential diagnosis of gastric lesions: The value of contrast enhanced sonography with gastric distention.

From the 107 gastric lesions, 75 were malignant gastric lesions (33 gastric cancers,42 gastrointestinal stromal tumors (GISTs)) and 32 were benign gastric lesions (11 inflammatory masses and 21 polypoid adenomas). Compared with US, DCUS achieved higher value in sensitivity (90.6% vs. 70.6%), specificity (75% vs. 62.5%), positive predictive value (89.5% vs. 81.5%), negative predictive value (77.4% vs. 47.6%), and overall accuracy (85.9% vs. 68.2%). When US was tested against DCUS, the increase in correct diagnoses value was significant (P = .01). Furthermore, gastric cancer had faster AT, higher PI and AUC than normal tissue (P<0.05); GIST and Inflammatory mass had higher PI than normal tissue (P<0.05); gastric cancer and GIST had faster AT than polypoid adenoma (P<0.05), Inflammatory mass showed higher PI than other 3 lesions and gastric cancer had higher PI than polypoid adenoma and GIST (P<0.05); gastric cancer and inflammatory mass had larger AUC than polypoid adenoma and GIST (P<0.05). Conclusion DCUS improved diagnostic performance compared with US. The combination of different CEUS enhancement characteristics with quantitative perfusion parameters may provide a promising tool to help differentiate gastric cancer and GIST from benign lesions.