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Kanzaki H, Uedo N, Ishihara R, Nagai K, Matsui F, Ohta T, Hanafusa M, Hanaoka N, Takeuchi Y, Higashino K, Iishi H, Tomita Y, Tatsuta M, Yamamoto K. Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis. Helicobacter 2012; 17:224-31. [PMID: 22515361 PMCID: PMC3489050 DOI: 10.1111/j.1523-5378.2012.00938.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Barium radiographic studies have suggested the importance of evaluating areae gastricae pattern for the diagnosis of gastritis. Significance of endoscopic appearance of areae gastricae in the diagnosis of chronic atrophic fundic gastritis (CAFG) was investigated by image-enhanced endoscopy. MATERIALS AND METHODS Endoscopic images of the corpus lesser curvature were studied in 50 patients with CAFG. Extent of CAFG was evaluated with autofluorescence imaging endoscopy. The areae gastricae pattern was evaluated with 0.2% indigo carmine chromoendoscopy. Micro-mucosal structure was examined with magnifying chromoendoscopy and narrow band imaging. RESULTS In patients with small extent of CAFG, polygonal areae gastricae separated by a narrow intervening part of areae gastricae was observed, whereas in patients with wide extent of CAFG, the size of the areae gastricae decreased and the width of the intervening part of areae gastricae increased (p < 0.001). Most areae gastricae showed a foveola-type micro-mucosal structure (82.7%), while intervening part of areae gastricae had a groove-type structure (98.0%, p < 0.001). Groove-type mucosa had a higher grade of atrophy (p < 0.001) and intestinal metaplasia (p < 0.001) compared with foveola type. CONCLUSIONS As extent of CAFG widened, multifocal groove-type mucosa that had high-grade atrophy and intestinal metaplasia developed among areae gastricae and increased along the intervening part of areae gastricae. Our observations facilitate our understanding of the development and progression of CAFG.
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Affiliation(s)
- Hiromitsu Kanzaki
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan,Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOkayama, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Kengo Nagai
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Fumi Matsui
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Takashi Ohta
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Masao Hanafusa
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Noboru Hanaoka
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Hiroyasu Iishi
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Yasuhiko Tomita
- Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Masaharu Tatsuta
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, Osaka, Japan
| | - Kazuhide Yamamoto
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOkayama, Japan
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TAKECHI K, OHASHI M, KODA K, SHIMOJO H, MORIWAKI H, MUTO Y, YAMADA T. Gastric Pit Density and Depth of Foveolae of the Gastric Body Mucosa Assessed by Dye Endoscopy. Dig Endosc 2007. [DOI: 10.1111/j.1443-1661.1993.tb00623.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- Keishi TAKECHI
- Department of Internal Medicine, Yoro Central Hospital, Gifu, Japan
| | - Miyoji OHASHI
- Department of Internal Medicine, Yoro Central Hospital, Gifu, Japan
| | - Koji KODA
- First Department of Internal Medicine, Gifu University School of Medicine, Gifu, Japan
| | - Hirofumi SHIMOJO
- Department of Internal Medicine, Yoro Central Hospital, Gifu, Japan
| | | | - Yasutoshi MUTO
- Department of Internal Medicine, Yoro Central Hospital, Gifu, Japan
| | - Tetsuya YAMADA
- Second Department of Pathology, Gifu University School of Medicine, Gifu, Japan
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Abstract
Gastritis is a histologic diagnosis. To understand gastritis, the radiologist must have some working knowledge of gastric histology and pathology. Therefore, this article first describes normal histologic and radiologic anatomy. The pathology of gastritis is then presented to give the radiologist a basis for understanding the radiologic findings. Finally, gastritis is discussed from a clinical and radiologic perspective.
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Affiliation(s)
- S E Rubesin
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Levine MS, Palman CL, Rubesin SE, Laufer I, Herlinger H. Atrophic gastritis in pernicious anemia: diagnosis by double-contrast radiography. GASTROINTESTINAL RADIOLOGY 1989; 14:215-9. [PMID: 2731694 DOI: 10.1007/bf01889200] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A retrospective study was performed to determine whether the areae gastricae pattern in the stomach or other radiologic features could be used on double-contrast upper gastrointestinal examinations to accurately diagnose atrophic gastritis in pernicious anemia. The double-contrast studies from 21 patients with pernicious anemia and 55 age-matched controls were interspersed and reviewed blindly to assess gastric size, mucosal folds, and the areae gastricae pattern in the stomach. The best set of criteria for differentiating the pernicious anemia group from the controls included a fundal diameter of 8 cm or less, absent mucosal folds in the fundus or body, and small (i.e., 1-2 mm in size) or absent areae gastricae. This combination of findings was present in 81% of patients with pernicious anemia but it also was present in 11% of the controls, so that atrophic gastritis in pernicious anemia could not be reliably diagnosed on radiologic criteria. Nevertheless, patients with pernicious anemia invariably had small or absent areae gastricae in the stomach, so that the presence of prominent areae gastricae, particularly in the fundus, may be a useful criterion for excluding this disease.
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Affiliation(s)
- M S Levine
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104
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