Akademik Veri Yönetim Sistemi
Ankara Üniversitesi Tıp Fakültesi Mecmuası, cilt.76, sa.1, ss.37-44, 2023 (Hakemli Dergi)
Objectives: Bile reflux gastritis is an underdiagnosed but common type of chemical gastritis (CG) caused by bile induced irritation of gastric mucosa. Diagnosis is based on endoscopic and histologic findings. However, if bile reflux is not observed, diagnosis of bile gastritis might be challenging. We aimed to evaluate duodenogastric gadoxetic acid (GA) reflux in routine liver magnetic resonance imaging (MRI) and to compare this finding with bile reflux and gastritis findings in upper endoscopy. Materials and Methods: A total of consecutive 45 patients who underwent GA-enhanced liver MRI with at least one delayed phase image (≥40 minutes delay) and upper endoscopy were retrospectively included. Images were reviewed by two radiologists regarding the presence and extent of gastric GA. Endoscopic and histologic results were noted. Results: Duodenogastric GA reflux was detected in 8 patients (17.8%). In 2 of them endoscopy revealed bile reflux. In one of these two patients gastritis was also noted,whereas gastric mucosa was considered as normal in the other patient. In 6 out of 8 patients with contrast reflux gastric bile stain was not reported. In each of these 6 patients erosive/erythematous gastritis was detected. Histopathology confirmed CG in 4 out of them. Conclusion: It might be challenging to differentiate bile induced gastritits from other types of CG, in particular, if gastric bile stain is not observed during upper endoscopy. Thus, radiologists should be aware of duodenogastric GA reflux on delayed phase MRI and report this finding. We suggest, that diagnostic performance of MRI regarding bile reflux and bile gastritis should be investigated with a multidisciplinary prospective study design.