评估口服胃肠超声造影剂联合静脉注射双重超声造影在早期胃癌诊断中的研究。

对65例疑似早期胃癌的患者行口服胃肠超声造影剂联合静脉注射双重超声造影检查，最终有48例被病理确诊为早期胃癌。以病理结果作为参考标准，对比分析单独使用口服胃肠超声造影剂与双重超声造影检查的诊断效能；通过观察病变位置、范围、局部胃壁层次结构改变及血流灌注特征分析双重超声造影在早期胃癌术前T分期预评估的准确性及其临床意义。

单纯口服胃肠造影剂后超声显示早期胃癌胃黏膜低回声隆起或局部增厚，联合静脉超声造影显示病灶呈高灌注增强、消退快，二者检出率分别为55.39%、70.77%，诊断敏感度为75.00%、95.83%，特异度为70.59%、88.24%，准确度为73.85%、93.85%，漏诊率为25.00%、4.17%，P＜0.05，差异有统计学意义；二者阳性预测值87.81%、95.83%，P＞0.05，差异无统计学意义；双重超声造影检查术前T分期结果的准确性为97.92%。

双重超声造影可清晰显示早期胃癌的位置、范围、胃壁层次侵犯程度及血流灌注特征，对提高早期胃癌检出率和术前T分期预评估有重要意义。

To evaluate the value of oral-intravenous dual-contrast gastrointestinal ultrasound in the diagnosis of early gastric cancer.

A total of 65 patients suspected of having early gastric cancer who underwent oral-intravenous dual-contrast gastrointestinal ultrasound were included. Pathological examination confirmed early gastric cancer in 48 cases. The diagnostic accuracy of oral contrast-enhanced ultrasound alone was compared with that of dual-contrast ultrasound, using pathological findings as the reference standard. Furthermore, by evaluating lesion location, extent, alterations in the layered structure of the gastric wall, and blood flow perfusion characteristics, the accuracy and clinical significance of dual-contrast ultrasound in preoperative T-staging of early gastric cancer were analyzed.

After oral gastrointestinal contrast-enhanced ultrasound alone, early gastric cancer lesions appeared as hypoechoic protrusions or localized thickening of the gastric wall. With dual-contrast ultrasound (combined oral and intravenous contrast), the lesions demonstrated hyperenhancement in the arterial phase with rapid washout in the venous phase. The detection rate for oral contrast-enhanced ultrasound alone and dual-contrast ultrasound was 55.39% and 70.77%, respectively; the sensitivity was 75.00% and 95.83%; the specificity was 70.59% and 88.24%; the accuracy was 73.85% and 93.85%; and the missed diagnosis rate was 25.00% and 4.17%, respectively. All these differences were statistically significant (P＜0.05). The positive predictive value was 87.81% and 95.83%, respectively, and this difference was not statistically significant (P＞0.05). The accuracy of T-staging by dual-contrast ultrasound was 97.92%.

Dual-contrast ultrasound can clearly delineate the location, extent, layer invasion depth, and blood perfusion characteristics of early gastric cancer, playing a significant role in improving the detection rate and preoperative T-staging accuracy of early gastric cancer.