ANTRAL NODULARITY, FOLD THICKNESS, AND NARROWING - SIGNS ON THE UPPERGASTROINTESTINAL SERIES THAT MAY INDICATE CHRONIC ACTIVE GASTRITIS SECONDARY TO HELICOBACTER-PYLORI

RATIONALE AND OBJECTIVES. The purpose of this retrospective study was to investigate any association between the classic radiographic findin gs of nonerosive gastritis on the upper gastrointestinal (GI) series ( antral nodularity, fold thickening, and narrowing) and histologically proven gastritis secondary to Helicobacter pylori. METHODS. The author s reviewed the histopathologic results of 31 patients who had upper GI barium examinations with the findings listed above who presented with dyspepsia, These patients were compared with 30 dyspeptic patients wh o had radiographically normal antrums, RESULTS. Twenty (64.5%) patient s had chronic active gastritis and tested positive for H pylori organi sm, 5 (16.1%) were normal, 5 (16.1%) had inflammation but were negativ e for H pylori, and 1 (3.2%) had an insufficient amount of tissue, The barium upper GI series was 66.7% sensitive and 69.4% specific for chr onic active gastritis secondary to H pylori (P = 0.0002 Fisher's exact test), with a positive predictive value of 64.5% and a negative predi ctive value of 83.3%. CONCLUSIONS. The differential diagnosis for antr al nodularity, fold thickening, and narrowing is extensive, However, b ecause of the common histopathologic diagnosis of chronic active gastr itis secondary to H pylori in patients with these radiographic finding s, the radiologist must remember to include this infectious cause of g astritis in the interpretive report, If the antrum is normal on the up per GI series, other causes should be considered.