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.