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Radiographically diagnosed antral gastritis: findings in patients with and without Helicobacter pylori infection

S Dheer, MD1, M S Levine, MD1, R O Redfern, RT (R) (ARRT)1, D C Metz, MD2, S E Rubesin, MD1 and I Laufer, MD1

Departments of 1 Radiology and 2 Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA



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Figure 1. 88-year-old woman with antral gastritis. Supine oblique image from double contrast study shows mildly thickened, scalloped folds (black arrows) in the antrum. Note transverse orientation of folds. Some barium precipitates (white arrows) are also seen in the antrum. Endoscopy revealed moderate inflammation of the antrum, and biopsy specimens from this region confirmed the presence of antral gastritis. This patient was Helicobacter pylori positive and had no history of non-steroidal anti-inflammatory drug use.

 


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Figure 2. 38-year-old woman with polypoid antral gastritis. Supine oblique image from double contrast study shows markedly thickened, lobulated folds (arrows) in the antrum. Endoscopy revealed severe inflammation of the antrum, and biopsy specimens from this region confirmed the presence of antral gastritis. All of our patients with polypoid antral gastritis were Helicobacter pylori positive.

 


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Figure 3. 41-year-old woman with erosive antral gastritis. Supine oblique spot image from double contrast study shows multiple varioliform erosions in the antrum as punctate collections of barium (arrowheads) surrounded by radiolucent mounds of oedema (arrows). Endoscopy revealed visible signs of antral gastritis, but no biopsy specimens were obtained. Almost all of our patients with antral erosions were Helicobacter pylori negative (including this patient), and nearly half had a history of recent aspirin or other non-steroidal anti-inflammatory drug use.

 


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Figure 4. 68-year-old woman with antral gastritis. Supine oblique image from double contrast study shows enlarged areae gastricae (white arrows) in the antrum and body of the stomach as well as a thickened antral fold (black arrow). Endoscopy revealed inflammation of the antrum, and the CLOtest was positive for Helicobacter pylori. All of our patients with enlarged areae gastricae were H. pylori positive.

 





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