背景:人们一致认为,识别栅栏血管(DEPV)的远端对于诊断胃食管交界处(GEJ)很重要。然而,尚未建立最佳观察方法。这项研究调查了使用有效的图像增强内窥镜(IEE)进行DEPV检测。
方法:用白光成像(Olympus-WLI和Fujifilm-WLI)和IEE(窄带成像;RDI1/2/3,红色二色性成像;纹理和色彩增强成像1/2;蓝色激光成像;和LCI,链接彩色成像)记录的20例GEO的内窥镜图像由两个制造商进行评估和评估。在图像上放置了来自管腔中心的多达24条径向直线,评估人员根据置信水平(高,低,并且不可检测)在DEPV位置。分析了评估者之间标记的置信水平和变异系数的可检测性和可重复性。
结果:总计,获得了15,180个标记。在可检测性方面,RDI1(49.4%),RDI2(53.0%),RDI3(54.1%),TXI2(49.7%),LCI(34.6%)在每个制造商的IEE中具有明显更高的高置信度。相比之下,奥林巴斯-WLI(40.6%),富士胶片-WLI(17.6%),窄带成像(15.9%),蓝色激光成像(9.8%)的高置信度明显较低。关于再现性,RDI3和LCI对于每个制造商具有最低的变异系数。
结论:RDI和LCI可能是检测GEJ区柱状化生粘膜中DEPV的可靠方法。
BACKGROUND: There is a consensus that identifying the distal end of the palisade vessels (DEPV) is important for diagnosing gastroesophageal junction (GEJ). However, optimum observation methods have not been established. This study investigated the use of effective image-enhanced endoscopy (IEE) for DEPV detection.
METHODS: One hundred endoscopic images in 20 cases of columnar metaplastic mucosa of the GEJ recorded with white-light imaging (Olympus-WLI and Fujifilm-WLI) and IEEs (narrow-band imaging; RDI1/2/3, red dichromatic imaging; texture and color enhancement imaging 1/2; blue-laser imaging; and LCI, linked color imaging) from two manufacturers were extracted and evaluated by 10 evaluators. Up to 24 radial straight lines from the center of the lumen were placed on the image, and the evaluators placed markings according to confidence level (high, low, and not detectable) at the DEPV locations. The detectability and reproducibility at the rate of the confidence level and coefficient of variance of markings among the evaluator were analyzed.
RESULTS: In total, 15,180 markings were obtained. In terms of detectability, RDI1 (49.4%), RDI2 (53.0%), RDI3 (54.1%), TXI2 (49.7%), and LCI (34.6%) had a significantly higher rate of high confidence among the IEEs in each manufacturer. By contrast, Olympus-WLI (40.6%), Fujifilm-WLI (17.6%), narrow-band imaging (15.9%), and blue laser imaging (9.8%) presented with a significantly lower rates of high confidence. Regarding reproducibility, RDI3 and LCI had the lowest coefficient of variance for each manufacturer.
CONCLUSIONS: RDI and LCI could be reliable modalities for detecting DEPVs in the columnar metaplastic mucosa of the GEJ zone.