残胃炎影像特征和幽门螺杆菌相关性的临床分析
胃炎；螺杆菌,幽门；钡；检查,,胃炎；螺杆菌，幽门；钡；检查,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨幽门螺杆菌阳性和阴性残胃炎的各种双对比影像特征及其临床应用价值。方法 按统一标准对所获材料进行筛选和回顾性分析；各X线征象诊断标准：胃黏膜皱襞宽度≥5mm或较其他部位胃黏膜皱襞显著增厚(限局性)即诊断为胃黏膜皱襞增厚。吻合口直径≤9mm即诊断为吻合口狭窄。溃疡和胃黏膜糜烂照常规诊断。统计检验各X线征象和幽门螺杆菌的关系。结果 共筛选出52例病例，其中25例幽门螺杆菌阳性，27例阴性。幽门螺杆菌阳性病例中有胃黏膜皱襞增厚23例(92.00%)、吻合口狭窄6例(24.00%)、溃疡1例(4.00%)，胃黏膜糜烂3例(12.00%)；幽门螺杆菌阴性病例中则分别有19例(70.37%)(P<0.05)、1例(3.70%)(P<0.001)、2例(7.41%)(P>0.05)、4例(14.81%)(P>0.05)。结论 幽门螺杆菌可能主要引起残胃黏膜增生性病变，相应的则在双对比影像上出现胃黏膜皱襞增厚和吻合口狭窄，而残胃溃疡和胃黏膜糜烂则不能表示有幽门螺杆菌感染。【关键词】 胃炎；螺杆菌，幽门；钡；检查
Comparative study on radiological features of remnant gastritis between the H.pylori-positive patients and the H.pylori-negative patients
QIAN Xue-qun,GU Qiang,WEN Feng,et al.
Department of Radiology,Pudong New Area Peoples Hospital,Shanghai 201200,China
【Abstract】 Objective To investigate the radiological spectrum of Helicobacter pylori-positive or-negative remnant gastritis and its clinical application value.Methods Ninety-eight patients who had undergone GI examinations were screened and retrospectively studied.The screening standards were:(1)The pathological tests of H.pylori were performed within 6 months before or after GI.(2)The methods of gastrointestinal reconstruction were Billroth Ⅰ (including esophagogastrostomy) and Billroth Ⅱ.(3)Remnant gastritis was proven by gastroscopy and pathological biopsy,and the possibilities of malignant tumor were excluded.(4)The GI images and the diagnosis were clear.The diagnosis standards were:(1)Folds 5 mm or greater in width or obviously thicker than other area of the remnant stomach were defined as thickened folds.(2)Stomas 9 mm or lesser in diameter were defined as stenosis.(3)When the niche sign was found,the diagnosis of ulcer was established.(4)When the barium flecks or other X-ray features of erosive gastritis were found,the diagnosis of gastric mucosal erosion was established.A statistical analysis of the data was performed with Fishers Exact test.Results According to the screening standards,the materials of 52 of 98 cases were satisfied.25 of the 52 cases were found to be H.pylori positive and 27 were found to be H.pylori negative.Thickened folds were detected in 23 (92.00%) H.pylori-positive cases vs 19 (70.37%) H.pylori-negative cases (P<0.05);stenotic stoma in 6 (24.00%) H.pylori-positive cases vs 1 (3.70%) H.pylori-negative cases (P<0.001);remnant gastric ulcers in 1 (4%) H.pylori-positive cases vs 2 (7.41%) H.pylori-negative cases (P>0.05);erosions in 3 (12.00%) H.pylori-positive cases vs 4 (14.81%) pylori-negative cases (P>0.05).Conclusion H.pylori might mainly cause mucosal proliferative lesion,accordingly thickened folds and stenotic stoma can be detected in H.pylori-positive patients,and the detection of ulcers or erosions can not identify the infection of H.pylori. ......
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