Double-Contrast Upper Gastrointestinal Radiography: A Pattern Approach for Diseases of the Stomach

Rubesin, Stephen E.; Levine, Marc S.; Laufer, Igor

doi:10.1148/radiol.2461061245

Cited by 60 publications

(20 citation statements)

References 87 publications

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“…The greatest risk of follow-up observation without UGI-ES is to erroneously diagnose protruded early gastric cancers as nonmalignant gastric polyps, but our results indicate such misdiagnoses are quite rare. Nowadays, it has been gradually accepted that UGI-XR can detect not only gastric cancer but also premalignant atrophic/hypertrophic gastritis [4,25,30,32]. Our recent report demonstrated that UGI-XR can diagnose chronic H. pylori infection with very high accuracy (97.8 %; 1638 of 1674 subjects) [5].…”

Section: Discussionmentioning

confidence: 93%

“…Since the 1960s, the UGI-XR-based gastric cancer screening program endorsed by the Japanese government has achieved a significant reduction in mortality and morbidity of gastric cancer [1][2][3]. UGI-XR can detect not only gastric cancer but also gastroduodenal erosion or ulcer, gastric or esophageal polyps, esophagogastric diverticula, atrophic or hypertrophic gastritis, esophageal hiatal hernia, and other lesions [4,5]. Of these various lesions, gastric polyp is one of the most frequent findings observed in the usual screening examination [6].…”

Section: Introductionmentioning

confidence: 99%

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Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan

et al. 2016

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Background Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) is a method broadly used for gastric cancer screening in Japan. Gastric polyp is one of the most frequent findings detected by UGI-XR, but how to handle it remains controversial. Methods Gastric polyps of the 17,264 generally healthy subjects in Japan who underwent UGI-XR or upper gastrointestinal endoscopy (UGI-ES) in 2010 were analyzed. Results Of the 6,433 UGI-XR examinees (3,405 men and 3,028 women, 47.4 ± 9.0 years old), gastric polyps were detected in 464 men (13.6 %) and 733 women (24.2 %) and were predominantly developed on the non-atrophic gastric mucosa (p \ 0.0001). Multiple logistic regression analysis showed that the presence of gastric polyps has significant association with lower value of serum antiHelicobacter pylori IgG titer, female gender, lighter smoking habit, older age, and normal range of body mass index ( ‡18.5 and \25), but not with drinking or serum pepsinogen I/II ratio. During the 3-year follow-up, gastric cancer occurred in 7 subjects (0.11 %), but none of them had gastric polyps at the beginning of the follow-up period. Of the 2,722 subjects with gastric polyps among the 10,831 UGI-ES examinees in the same period, 2,446 (89.9 %) had fundic, 267 (9.8 %) had hyperplastic, and 9 (0.3 %) had adenomatous/cancerous polyps. Conclusions Gastric polyps diagnosed by UGI-XR predominantly arise on the Helicobacter pylori-negative gastric mucosa with a low risk of gastric cancer in Japan. In the prospective observation, none of the UGI-XR examinees with gastric polyps developed gastric cancer for at least 3 years subsequently.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan

et al. 2016

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“…In Table S1, we provide all the data of our 962 study subjects, which include the Kimura-Takemoto classification of UGI-ES-based atrophic gastritis, the four-grade types of UGI-XR-based atrophic gastritis, serum titers of anti-H. pylori IgG, age, gender, body mass index, smoking history, alcohol use, serum pepsinogens, the ABCD risk classification of gastric cancer [9], the three-grade types of UGI-XR-based enlarged folds [24,25], etc. Extracted data of the 602 subjects without UGI-ES/UGI-XR-based atrophic gastritis and those of the 254 subjects with UGI-ES/UGI-XR-based atrophic gastritis are also provided in Tables S2 and S3.…”

Section: Discussionmentioning

confidence: 99%

“…By referring to several previous reports [23][24][25], we have recently established the four-grade classification of UGI-XR-based atrophic gastritis judging from the irregular shapes of areae gastricae and their expansion (normal, mild, moderate, and severe) [2]. These two categorizations of image-based atrophic gastritis and double/triple check of the images are minutely described in Fig.…”

Section: Study Subjectsmentioning

confidence: 99%

Comparative analysis of upper gastrointestinal endoscopy, double-contrast upper gastrointestinal barium X-ray radiography, and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis

et al. 2015

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Background Upper gastrointestinal endoscopy (UGI-ES) and double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) are two major image-based methods to diagnose atrophic gastritis, which is mostly induced by Helicobacter pylori infection. However, there have been few studies directly comparing them. Methods Atrophic gastritis was evaluated using the data of 962 healthy subjects who underwent UGI-ES and UGI-XR within 1 year. Results and conclusion Based on UGI-ES and UGI-XR, 602 subjects did not have atrophic gastritis and 254 subjects did have it. Considering UGI-ES-based atrophic gastritis as the standard, sensitivity and specificity of UGI-XR-based atrophic gastritis were 92.0 % (254/276) and 92.8 % (602/649), respectively. The seven-grade KimuraTakemoto classification of UGI-ES-based atrophic gastritis showed a strong and significant association with the fourgrade UGI-XR-based atrophic gastritis. Sensitivity and specificity of serum anti-Helicobacter pylori IgG to detect UGI-ES/UGI-XR-based atrophic gastritis were 89.4 % (227/254) and 99.8 % (601/602), indicating that atrophic gastritis can be overlooked according to serum anti-Helicobacter pylori IgG alone.Keywords Atrophic gastritis Á Helicobacter pylori Á Upper gastrointestinal endoscopy (UGI-ES) Á DoubleElectronic supplementary material The online version of this article

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“…Typical findings of gastritis include thin mucosal striations oriented perpendicular to the long axis of the gastric antrum, thickened rugal folds, and a granular appearance of the mucosa with numerous 1-to 2-mm mucosal nodules. 4 Peptic ulcers are mucosal defects that penetrate through the muscularis mucosa into the deeper layers of the gastric wall. These ulcers are demonstrated by either a focal barium pool within a depressed mucosal defect or a thin rim of barium outlining the margins of an unfilled ulcer.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori–Associated Antral Gastritis and Ulcer Disease

Swenson

Wallach

2012

Ultrasound Quarterly

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A 10-year-old male presented to the emergency department after several days of progressive epigastric pain, nausea, and vomiting. He was clinically dehydrated and had mild leukocytosis. Abdominal computed tomography (CT) was performed on the evening of presentation, revealing circumferential edema in the wall of the gastric antrum ( Fig. 1). There was a questionable mucosal defect at the posterior wall, raising concern for an ulcer (arrow, Fig. 1). Abdominal ultrasound was performed the following day, confirming antral gastritis (Fig. 2) and demonstrating a deep mucosal defect in the posterior wall, consistent with an ulcer (Fig. 3). Stool assays were positive for Helicobacter pylori. The patient was treated with carafate, proton pump inhibitors, and appropriate antibiotics. His symptoms improved rapidly, and within 2 weeks, he had returned to his clinical baseline. The patient remained asymptomatic for 3 months, after which, he was lost to follow-up. DIAGNOSISHelicobacter pyloriYassociated antral gastritis and ulcer disease. DISCUSSIONHelicobacter pylori is a common chronic bacterial infection that affects approximately 50% of the world population. 1,2 The infection is generally acquired early in life FIGURE 1. Axial contrast-enhanced CT through the level of the stomach demonstrates circumferential gastric antral wall thickening, mucosal enhancement, and submucosal hypoattenuation, which represents edema. There is mucosal irregularity at the posterior wall of the gastric antrum (arrow), raising suspicion for an ulcer.

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Double-Contrast Upper Gastrointestinal Radiography: A Pattern Approach for Diseases of the Stomach

Cited by 60 publications

References 87 publications

Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan

Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan

Comparative analysis of upper gastrointestinal endoscopy, double-contrast upper gastrointestinal barium X-ray radiography, and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis

Helicobacter pylori–Associated Antral Gastritis and Ulcer Disease

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