Radiology, Vol 178, 63-66, Copyright © 1991 by Radiological Society of North America
Detection of gastric erosions: comparison of biphasic radiography with fiberoptic endoscopy
PC Shaw, LK van Romunde, G Griffioen, AR Janssens, J Kreuning and CB Lamers
Department of Diagnostic Radiology, University Hospital of Leiden, The Netherlands.
Biphasic radiography was compared with fiberoptic endoscopy in detecting
gastric erosions in a prospective, blinded study of 385 patients with
dyspepsia. Because no absolute standard was available for the comparison,
since histologic confirmation of all erosions was not possible, the kappa
statistic was used to compare results from both modalities. Flat
(incomplete) erosions were detected with endoscopy only and were considered
to be present in 42 patients (11.2%). Varioliform (complete) erosions were
identified with both radiography and endoscopy in 12 patients (3.2%). For
the detection of varioliform erosions, a substantial agreement beyond
chance between both modalities was found (kappa = 0.73; standard error,
0.12). Thus, flat erosions were detected with endoscopy only, whereas
state-of-the-art radiography and endoscopy were equally sensitive for
detecting varioliform erosions. Histologic confirmation of erosions was
obtained in only 75% of the patients. It is unknown whether the
demonstration of erosions with radiography and/or endoscopy correlates with
dyspepsia.
