Radiographic examination of the stomach and duodenum: comparison of single-, double- and biphasic-contrast methods

We compared retrospectively three groups of 150 patients who had undergone radiologic examinations of the stomach and duodenum. Each group was examined with a different barium suspension and radiographic technique: single-contrast (SC), double-contrast (DC), or biphasic-contrast (BC). The radiographs of each study were evaluated for technical quality and visualization of lesions. The number of X-ray exposures, films, and the amount of fluoroscopic time for each study were tabulated. The total radiation dose and cost for each technique were calculated. The BC examinations required the greatest number of radiographic exposures and X-ray films; however, cost was highest for the DC method. Fluoroscopy was significantly longer during the DC procedures, and the total radiation dose was also highest with this technique. Gaseous distention and barium coating of the stomach were equally good for the BC and DC groups, but X-ray penetration of the barium suspension during compression filming was significantly better in the BC and SC groups. Areae gastricae were most frequently seen during the BC studies and artifacts from excess secretions, barium flocculation or gas bubbles were least commonly present using this technique. Significantly more lesions were demonstrated in the stomach with the BC technique than with the other methods; however, the number of lesions found in the duodenum was the same for each technique.