[Endosonography with electronic longitudinal scan in malignant diseases of the stomach]

To assess the significance of endoscopic ultrasonography (EUS) using an electronic longitudinal scan we examined 75 patients. 32 patients suffering from malignant diseases of the stomach (2 early cancers, 22 gastric carcinoma, 4 cancers of the cardia, 2 gastric lymphoma, 2 infiltration from outside). 31 of the 32 patients who had malignant gastric diseases were correctly diagnosed by means of EUS. The positive sensitivity was 96.9%, the positive predictive value was 86.1%. The specificity was 88.4%, the negative predictive value 97.4%. Using sonographical criteria such as thickening of the gastric wall, wall layers, delineation of outer and interior gastric wall, infiltration into the gastric wall, infiltration into neighbouring organs as well as perigastric lymph node, EUS provides reliable determination and staging of gastric tumours. Compared to conventional ultrasonography and gastric endoscopy, EUS affords considerable improvement in the diagnosis of gastric tumours, especially with regard to the identification of the infiltration of the tumour (84.4%), recognition of malignancy (28.1%), identification of the origin of the tumour (21.9%), and of regional lymph node metastases (25%).