Abdominal Imaging

, Volume 39, Issue 2, pp 424–431 | Cite as

Evaluation of transabdominal ultrasound after oral administration of an echoic cellulose-based gastric ultrasound contrast agent for demonstrating small gastric subepithelial masses

  • Zhijun Liu
  • Jintao Guo
  • Siyu Sun
  • Weidong RenEmail author
  • Shaoshan Tang
  • Limei Xie
  • Liping Huang



To assess the role of transabdominal ultrasound after oral administration of an echoic cellulose-based gastric contrast agent (TUS-OCCA) for detection and characterization of small gastric subepithelial masses (≤3 cm) by comparison with endosonography (EUS).


Ninety-five patients with small gastric subepithelial masses detected by gastroscopy examination were enrolled. For each patient, TUS-OCCA was performed prior to EUS by a skilled examiner. TUS-OCCA diagnoses were compared with those of EUS.


TUS-OCCA had a detection rate of 94% (89 of 95) in visualizing small gastric subepithelial masses previously detected by gastroscopy. The sizes of 6 undetected masses ranged from 7 to 12 mm (4 located at the fundus, 2 at the cardia). All of six patients whose lesions were undetected by TUS-OCCA were obese. The findings of gastric subepithelial masses demonstrated by TUS-OCCA were similar to that shown on EUS.


TUS-OCCA can provide useful information about small gastric subepithelial masses, especially for the patients who are not obese. It can be used to follow gastric submucosal tumors that are not excised.


Stomach Subepithelial masses Cellulose Gastric ultrasound contrast agent Gastrointestinal stromal tumor 



The authors declare no conflicts of interest.


  1. 1.
    American Gastroenterological Association Institute (2006) American Gastroenterological Association Institute medical position statement on the management of gastric subepithelial masses. Gastroenterology 130:2215–2216CrossRefGoogle Scholar
  2. 2.
    Kim MY, Jung HY, Choi KD, et al. (2011) Natural history of asymptomatic small gastric subepithelial tumors. J Clin Gastroenterol 45(4):330–336PubMedCrossRefGoogle Scholar
  3. 3.
    Zheng Z, Yu Y, Lu M, et al. (2011) Double contrast-enhanced ultrasonography for the preoperative evaluation of gastric cancer: a comparison to endoscopic ultrasonography with respect to histopathology. Am J Surg 202(5):605–611PubMedCrossRefGoogle Scholar
  4. 4.
    Xue N, Huang P, Aronow WS, et al. (2011) Predicting lymph node status in patients with early gastric carcinoma using double contrast-enhanced ultrasonography. Arch Med Sci 7(3):457–464PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Huang P, Li S, Aronow WS, et al. (2011) Double contrast-enhanced ultrasonography evaluation of preoperative Lauren classification of advanced gastric carcinoma. Arch Med Sci 7(2):287–293PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Shi H, Yu XH, Guo XZ, et al. (2012) Double contrast-enhanced two-dimensional and three-dimensional ultrasonography for evaluation of gastric lesions. World J Gastroenterol 18(31):4136–4144PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Li S, Huang P, Wang Z, et al. (2012) Preoperative T Staging of Advanced Gastric Cancer using Double Contrast-Enhanced Ultrasound. Ultraschall Med 33(7):E218–E224PubMedCrossRefGoogle Scholar
  8. 8.
    Liu Z, Guo J, Ren W, et al. (2013) A gastric calcifying fibrous pseudotumor detected by transabdominal ultrasound after oral administration of an echoic cellulose-based gastrointestinal ultrasound contrast agent. Ultraschall Med 34:1–3. doi: 10.1055/s-0033-1350396 CrossRefGoogle Scholar
  9. 9.
    Park SH, Kim GH, Park do Y, et al. (2011) Endosonographic findings of gastric ectopic pancreas: a single center experience. J Gastroenterol Hepatol 26(9):1441–1446PubMedGoogle Scholar
  10. 10.
    Guo J, Liu Z, Sun S, et al. (2013) Endosonography-assisted diagnosis and therapy of gastrointestinal submucosal tumors. Endosc Ultrasound 2(3):125–133CrossRefGoogle Scholar
  11. 11.
    Goto O, Kambe H, Niimi K, et al. (2012) Discrepancy in diagnosis of gastric submucosal tumor among esophagogastroduodenoscopy, CT, and endoscopic ultrasonography: a retrospective analysis of 93 consecutive cases. Abdom Imaging 37(6):1074–1078PubMedCrossRefGoogle Scholar
  12. 12.
    Okten RS, Kacar S, Kucukay F, et al. (2012) Gastric subepithelial masses: evaluation of multidetector CT (multiplanar reconstruction and virtual gastroscopy) versus endoscopic ultrasonography. Abdom Imaging 37(4):519–530PubMedCrossRefGoogle Scholar
  13. 13.
    Kongkam P, Devereaux BM, Ponnudurai R, et al. (2013) Endoscopic ultrasound forum summary from the Asian Pacific Digestive Week 2012. Endosc Ultrasound 2:43–60CrossRefGoogle Scholar
  14. 14.
    Giovannini M (2012) Report of EUS presentations during the 20th UEGW Meeting in Amsterdam. Endosc Ultrasound 1:169–172Google Scholar
  15. 15.
    Maconi G, Bianchi Porro G (2006) Ultrasound of the gastrointestinal tract: examination procedures and new technical developments. Berlin: SpringerGoogle Scholar
  16. 16.
    Polkowski M, Palucki J, Butruk E (2002) Transabdominal ultrasound for visualizing gastric submucosal tumors diagnosed by endosonography: can surveillance be simplified? Endoscopy 34:979–983PubMedCrossRefGoogle Scholar
  17. 17.
    Futagami K, Hata J, Haruma K, et al. (2001) Extracorporeal ultrasound is an effective diagnostic alternative to endoscopic ultrasound for gastric submucosal tumours. Scand J Gastroenterol 36:1222–1226PubMedCrossRefGoogle Scholar
  18. 18.
    Maconi G, Radice E, Bareggi E, et al. (2009) Hydrosonography of the gastrointestinal tract. Am J Roentgenol 193(3):700–708CrossRefGoogle Scholar
  19. 19.
    Lund PJ, Fritz TA, Unger EC, et al. (1992) Cellulose as a gastrointestinal US contrast agent. Radiology 185:783–788PubMedGoogle Scholar
  20. 20.
    Leung WK, Wu MS, Kakugawa Y, et al. (2008) Screening for gastric cancer in Asia: current evidence and practice. Lancet Oncol 9(3):279–287PubMedCrossRefGoogle Scholar
  21. 21.
    Nakajima S (2012) Gastric cancer screening in Japan, now and tomorrow. Nihon Rinsho 70(10):1686–1693PubMedGoogle Scholar
  22. 22.
    Lee KS, Oh DK, Han MA, et al. (2011) Gastric cancer screening in Korea: report on the national cancer screening program in 2008. Cancer Res Treat 43(2):83–88PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Jeong ID, Jung SW, Bang SJ, et al. (2011) Endoscopic enucleation for gastric subepithelial tumors originating in the muscularis propria layer. Surg Endosc 25(2):468–474PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Zhijun Liu
    • 1
  • Jintao Guo
    • 2
  • Siyu Sun
    • 2
  • Weidong Ren
    • 1
    Email author
  • Shaoshan Tang
    • 1
  • Limei Xie
    • 1
  • Liping Huang
    • 1
  1. 1.Ultrasound Department, Shengjing HospitalChina Medical UniversityShenyangChina
  2. 2.Endoscopy Center, Shengjing HospitalChina Medical UniversityShenyangChina

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