CAN THE RADIOLOGIST RECOGNIZE HELICOBACTER-PYLORI GASTRITIS

To evaluate radiologic findings of Helicobacter pylori (H. pylori) in the upper gastrointestinal (UGI) tract, we retrospectively reviewed co nsecutive records of 676 symptomatic adults with gastric biopsies (224 positive) and 150 symptomatic adults with rapid urease tests (57 posi tive). All the UGI series of patients with positive biopsies or urease tests for H. pylori were compared with the UGI series of patients wit h negative urease tests. UGI examinations were evaluated blindly by tw o gastrointestinal radiologists without knowledge of clinical findings , original radiologic interpretations, or test results. They agreed th at 8 of 18 (44%) UGIs of patients with H. pylori had abnormally increa sed gastric folds in the fundus, body, or antrum as compared with none of 14 (0%) UGIs of patients without H. pylori (p < 0.01) (P.P.V. = 1. 0). Interobserver agreement was good (kappa = 0.63). Endoscopy in the eight patients with radiographic evidence of enlarged gastric folds al l demonstrated marked abnormalities such as prominent gastric folds, g astric erythema, erosions, or peptic ulcers. Our findings indicate tha t enlarged gastric folds on the UGI series of a symptomatic adult are very suggestive of H. pylori gastritis.