Antral nodularity, fold thickness, and narrowing. Signs on the upper gastrointestinal 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 findings 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 authors 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 who had radiographically normal antrums.

RESULTS

Twenty (64.5%) patients had chronic active gastritis and tested positive for H pylori organism, 5 (16.1%) were normal, 5 (16.1%) had inflammation but were negative 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 chronic active gastritis secondary to H pylori (P = 0.0002 Fisher's exact test), with a positive predictive value of 64.5% and a negative predictive value of 83.3%.

CONCLUSIONS

The differential diagnosis for antral nodularity, fold thickening, and narrowing is extensive. However, because of the common histopathologic diagnosis of chronic active gastritis secondary to H pylori in patients with these radiographic findings, the radiologist must remember to include this infectious cause of gastritis in the interpretive report. If the antrum is normal on the upper GI series, other causes should be considered.