[Double contrast radiography of the stomach. Technique and results in early gastric cancer (author's transl)].

A technique for examination of the stomach is described and includes: induction of hypotony with medication, thin layer study of the anterior wall, and double contrast and compression. If there is close collaboration between the radiologist and the surgeon performing the endoscopy, this method can considerably improve diagnosis. Its application enabled 21 "early" cancers (as defined by the Japanese Society of Gastro-Enterology and Endoscopy) to be diagnosed out of 8 000 exsminations performed between 1971 and 1977. The smallest lesion measured 0.5 X 0.8 cm. The diagnostic value of this examination technique is about equal to that of fibroscopy, and a comparison of the different methods of radiological examination clearly demonstrates the superiority of double contrast for detecting small lesions: 19 of the 21 early cancers were visible in the double contrast images, while only 10 produced irregulrities in the walls as seen when filling had been completed, and 6 of the 21 lesions appeared during compression. This method is also very useful for the differential diagnosis of ulcers, ulcer scars, and early cancer. The following signs favour a malignant lesion: clear but irregular edges of depressed area with a nodular surface, convergent but interrupted folds with club deformity, and fusioning of the two folds giving a typical appearance. Flat cancerous lesions with diameters less than 1 cm are still extremely difficult to diagnose.