Objective To compare the accuracy of double contrast enhanced ultrasound (DCUS)with spiral CT in the preoperative evaluation of lymph node metastasis in gastric carcinomas.Methods This study included 150 patients with biopsy proven gastric cancer who underwent surgical resection as primary management of their malignancies.All patients underwent DCUS and spiral CT prior to surgery.The results of the ultrasound and CT findings were compared with the pathological results of the resected lymph nodes.Results According to the number of metastasis lymph nodes,the overall accuracy and that on each stage (N1,N2,N3) of DCUS and spiral CT was 86.0％ vs.81.4％,82.6％ vs.73.9％,78.1％ vs.75.0％ and 81.0％ vs.76.2％,there was no significant difference between them(P ＞0.05).By metastasis lymph node station,DCUS detected a higher percentage of positive lymph nodes than spiral CT at the first station(88.6％ vs.68.6％,x2 =4.158,P ＜0.05).Lymph nodes were correctly judged with DCUS and spiral CT in 74.1％ vs.81.5％ at second station and 71.4％ vs.78.6％ at third station respectively (P ＞ 0.05).Conclusions Double contrast-enhanced ultrasonography offers alternative reliable approach for the preoperative judging lymph node metastasis of gastric cancer.DCUS was comparable to spiral CT in lymph node station evaluation,DCUS offers an advantage in the detection of the first station lymph node metastases.