digital chromoendoscopy

数字色素内镜
  • 文章类型: Journal Article
    食管癌是全球癌症死亡的第六大原因。食管腺癌(EAC)的前兆是Barrett食管(BE)。早期诊断和治疗食管肿瘤(Barrett伴高度异型增生/粘膜内癌)可将5年生存率从10%提高到98%。是一个全球性的挑战;然而,目前用于早期BE检测的内窥镜成本很高,需要大量的基础设施来进行患者检查和镇静。我们描述了ScanCap的第一个原型的设计和评估,一个高分辨率的光学内窥镜系统,低成本系留胶囊,旨在提供高清晰度,蓝绿照明成像用于早期检测未镇静患者的BE。系留胶囊(直径12.8毫米,35.5毫米长)包含彩色相机和旋转镜,并设计为可吞咽;在胶囊通过系绳手动缩回时收集图像。系绳提供415nm和565nm波长的电力和照明,并将数据从相机传输到平板电脑。ScanCap原型胶囊用于对正常志愿者和离体食管切除的口腔粘膜进行成像;将图像与使用OlympusCV-180内窥镜获得的图像进行比较。在ScanCap图像中,完整口腔粘膜中的浅表毛细血管图像清晰可见。BE的诊断相关特征,包括不规则的Z线,粘膜扭曲,和扩张的脉管系统,在离体食管标本的ScanCap图像中清晰可见。
    Esophageal carcinoma is the sixth-leading cause of cancer death worldwide. A precursor to esophageal adenocarcinoma (EAC) is Barrett\'s Esophagus (BE). Early-stage diagnosis and treatment of esophageal neoplasia (Barrett\'s with high-grade dysplasia/intramucosal cancer) increase the five-year survival rate from 10% to 98%. BE is a global challenge; however, current endoscopes for early BE detection are costly and require extensive infrastructure for patient examination and sedation. We describe the design and evaluation of the first prototype of ScanCap, a high-resolution optical endoscopy system with a reusable, low-cost tethered capsule, designed to provide high-definition, blue-green illumination imaging for the early detection of BE in unsedated patients. The tethered capsule (12.8 mm diameter, 35.5 mm length) contains a color camera and rotating mirror and is designed to be swallowed; images are collected as the capsule is retracted manually via the tether. The tether provides electrical power and illumination at wavelengths of 415 nm and 565 nm and transmits data from the camera to a tablet. The ScanCap prototype capsule was used to image the oral mucosa in normal volunteers and ex vivo esophageal resections; images were compared to those obtained using an Olympus CV-180 endoscope. Images of superficial capillaries in intact oral mucosa were clearly visible in ScanCap images. Diagnostically relevant features of BE, including irregular Z-lines, distorted mucosa, and dilated vasculature, were clearly visible in ScanCap images of ex vivo esophageal specimens.
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  • 文章类型: Journal Article
    目的:入口贴片(IP)是胃外部存在的胃柱状上皮。在墨西哥尚未对该病理学进行研究。本研究的目的是确定食管IP的患病率和存在它的患者的临床特征。
    方法:进行了一项横断面研究,包括在2015年9月至2016年5月的时间范围内连续接受内窥镜检查的患者。病人回答了一份问卷,并进行了数字色素内镜的高清内镜检查。确定了IP的患病率。卡方检验用于比较出现食管IP的患者和没有食管IP的患者之间的临床特征。
    结果:共239例患者纳入研究。他们的平均年龄是53岁,130名(54.4%)是女性。在26例患者中发现IP(10.9%),其中15人为男性(57.7%)。转诊内镜的主要原因是胃食管反流病,69.2%的IP患者和55.9%的无IP患者(p=.19)。最常见的症状是胃灼热和反流。前者存在于有IP的患者的69.2%和无IP的59.1%(p=0.32),后者存在于有IP的患者中的65.4%和无IP的患者中的69.1%(p=.7)。食管外表现分布为:有IP的患者中有46.2%的咳嗽,无IP的患者中有38%的咳嗽(p=.45),有IP的患者中有54%的发音障碍,无IP的患者中有47%的发音障碍(p=.53)。23%的IP患者患有Barrett食管,23%没有IP(p=.99)。
    结论:IP的患病率很高。主要转诊诊断为胃食管反流病。有和没有IP的患者在症状或Barrett食管的存在方面没有发现差异。
    OBJECTIVE: An inlet patch (IP) is the presence of gastric columnar epithelium outside of the stomach. No studies have been conducted in Mexico on that pathology. The aim of the present study was to determine the prevalence of esophageal IP and the clinical characteristics of the patients that present it.
    METHODS: A cross-sectional study was conducted that included consecutive patients referred for endoscopy within the time frame of September 2015 to May 2016. The patients answered a questionnaire, and high-definition endoscopy with digital chromoendoscopy was performed. The prevalence of IP was identified. The chi-square test was used to compare the clinical characteristics between patients that presented with esophageal IP and those without it.
    RESULTS: A total of 239 patients were included in the study. Their mean age was 53 years, and 130 (54.4%) were women. IP was found in 26 patients (10.9%), 15 of whom were men (57.7%). The main reason for referral to endoscopy was gastroesophageal reflux disease, present in 69.2% of the patients with IP and in 55.9% without IP (p=.19). The most common symptoms were heartburn and regurgitation. The former was present in 69.2% of the patients with IP and in 59.1% without IP (p=.32), and the latter was present in 65.4% of the patients with IP and 69.1% without IP (p=.7). Extraesophageal manifestation distribution was: cough in 46.2% of the patients with IP and 38% without IP (p=.45) and dysphonia in 54% with IP and 47% without IP (p=.53). Twenty-three percent of the patients with IP had Barrett\'s esophagus, as did 23% without IP (p=.99).
    CONCLUSIONS: The prevalence of IP was high. The primary referral diagnosis was gastroesophageal reflux disease. No differences were found in relation to symptoms or the presence of Barrett\'s esophagus between the patients with and without IP.
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  • 文章类型: Journal Article
    胃肠道(GI)肿瘤是全世界最常诊断的癌症,并且是癌症相关死亡的第二大原因。内窥镜检查是诊断胃肠道癌症的金标准。在癌前或早期通过内窥镜检查早期诊断胃肠道肿瘤可能会降低胃肠道肿瘤的患病率和死亡率。内窥镜干预的预防作用和常规白光内窥镜检查的局限性引起了无数的创新。带有染料注射的彩色内窥镜检查可用于早期检测病变。然而,手术时间延长和学习曲线陡峭是色素内镜检查的缺点.成像增强的最新技术进步使得无需注射染料即可检测胃肠道病变。使用数字色素内窥镜系统,其中灵活的光谱成像颜色增强,窄带成像,和I-扫描是最常用的。内窥镜图像放大和使用数字内窥镜方法的高清光学系统的结合增加了内窥镜的诊断价值。共聚焦激光显微内镜的发展也改善了体内内窥镜诊断。本文重点介绍了内窥镜检查的最新技术创新。
    Gastrointestinal (GI) tumors are the most commonly diagnosed cancers worldwide and the second leading cause of cancer-related death. Endoscopy is the gold standard for diagnosis of GI cancers. Early diagnosis of GI tumors by endoscopy at the precancerous or early stage may decrease the prevalence and mortality rate of GI cancers. The preventive role of endoscopic interventions and the limitations of conventional white-light endoscopy have given rise to myriad innovations. Chromoendoscopy with dye injection can be used to detect lesions at an early stage. However, the prolonged procedure duration and steep learning curve are disadvantages of chromoendoscopy. Recent technological advances in imaging enhancement have enabled detection of GI lesions without the need for dye injection, using digital chromoendoscopy systems, of which flexible spectral-imaging color enhancement, narrow-band imaging, and I-Scan are the most frequently used. The combination of endoscopic image magnification and high-definition optical systems using digital endoscopic methods has increased the diagnostic value of endoscopy. The development of confocal laser endomicroscopy has also improved in vivo endoscopic diagnosis. This review focuses on the latest technological innovations in endoscopy.
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  • 文章类型: Journal Article
    图像技术的进步允许更详细地识别粘膜结构,并可能改善腺瘤的检测。这篇综述提供了有关单个成像技术及其对腺瘤检测的影响的技术概述。只有高清晰度内窥镜检查已被证明可以改善小腺瘤的检测。数字色素内镜技术都不能改善腺瘤的检测。对自身免疫荧光成像与高清内窥镜检查的有限研究可能会改善小腺瘤的检测。
    Advancements in image technology have allowed recognition of mucosal architecture in more detail and may improve adenoma detection. This review provides a technical overview on individual imaging technologies and their effect on detection of adenomas. Only high-definition endoscopy has been shown to improve detection of small adenomas. None of the digital chromoendoscopy technologies improves adenoma detection. Limited studies on autoimmunfluorescence imaging in conjunction with high-definition endoscopy may improve detection of small adenomas.
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