Gastrointestinal imaging with hydrosonography and hydro-CT .1. Gastric carcinoma

Purpose: Hydrosonography (HUS) and hydro-CT (HCT) were evaluated for diagnostic accuracy and staging efficiency of gastric carcinomas. Material and methods: 68 patients suspected for gastric carcinoma were examined. At HUS the gastric wall is distended by water, the tumour is localised and enlarged to judge the depth of infiltration. At HCT the stomach is filled with water and after paralysis of the gut a spiral-CT optimised for parenchymal and vessel contrast is performed. Gastric carcinomas were classified according to the TNM-system and histopathological correlation was achieved. Results: The number of normal/pathologic examinations was 10/30 (HUS) and 9/31 (HCT), the detection rate of gastric tumours was 77 % (HUS) and 94 % (HCT). The T-stage was correctly determined in 27 % (HUS) and 55 % (HCT), the N-stage in 65 % and 45 % and the M-stage in 81 % and 73 % of all cases, respectively. Conclusion: HCT is a reliable screening method for gastric tumours. Staging of gastric carcinomas, however, is not improved. Tumour extension beyond the wall and metastases can be assessed by a single examination.