虚拟色素内镜在小肠黏膜病损成像中的应用价值  

The application value of virtual chromoendoscopy in small bowel lesions endoscopy imaging

作　　者：孔刚[1] 刘虹[1] 龚志军[1] 郭建平[1] 

机构地区：[1]广东省江门市中心医院胃肠外科,广东江门529030

出　　处：《中国内镜杂志》2015年第6期603-606,共4页China Journal of Endoscopy

摘　　要：目的评价虚拟色素内镜在小肠黏膜病损成像中的应用价值。方法采用单中心回顾性研究方法,将白光胶囊内镜获取的49例100处小肠病损图像,由两位内镜专家分别在FIC E1、FIC E2、FIC E3及BF 4种条件下重建病损图像,并与白光胶囊内镜获取图像进行比较。K appa系数评价两位专家判别结果的一致性。100处小肠病损包括39处血管病损、49处溃疡（糜烂）病损及12例处水肿（萎缩）病损。结果采用FIC E1、FIC E2、FIC E3和BF图像重建条件后,小肠黏膜病损图像质量提高率分别为77%（77/100）、74%（74/100）、41%（41/100）和39%（39/100）,两位专家之间评价一致性程度分别为89%[k=0.833（P〈0.001）,95%C I：0.741-0.925]、85%[k=0.764（P〈0.001）,95%C I：0.654-0.874]、66%[k=0.486（P〈0.001）,95%C I：0.345-0.627]及79%[k=0.593（P〈0.001）,95%C I：0.438-0.748]。结论在常规SBC E-W L对小肠病损成像与表征不直观情况下,可使用虚拟色素内镜检查（尤其是FIC E1）,可将虚拟色素内镜检查作为常规白光SBC E检查的补充,用以评估难以解读的内镜图像。【Objective】To evaluate whether virtual chromoendoscopy can improve the delineation of small bowel lesions previously detected by conventional white light small bowel capsule endoscopy（SBCE）. 【Methods】Retrospective single center study was conducted. One hundred lesions selected from forty-nine consecutive conventional white light SBCE（SBCE-WL） examinations were included. Lesions were reviewed at three Flexible Spectral Imaging Color Enhancement（FICE） settings and Blue Filter（BF） by two gastroenterologists with experience in SBCE, blinded to each other＇s findings, who ranked the quality of delineation as better, equivalent or worse than conventional SBCE-WL. Inter-observer percentage of agreement was determined and analyzed with Fleiss Kappa（k） coefficient.Lesions selected for the study included angioectasias（n =39）, ulcers/erosions（n =49） and villous edema/atrophy（n =12）. 【Results】Overall, the delineation of lesions was improved in 77% of cases with FICE 1, 74% with FICE 2,41% with FICE 3 and 39% with the BF, with a percentage of agreement between investigators of 89%（κ =0.833）,85%（κ =0.764）, 66%（κ =0.486） and 79%（κ =0.593）, respectively.【Conclusion】Virtual chromoendoscopy can improve the delineation of angioectasias, ulcers/erosions and villous edema/atrophy detected by SBCE.

关 键 词：胶囊内镜 虚拟内镜 小肠内镜 可扩展电子分光色彩强调技术 

分 类 号：R656.7[医药卫生—外科学]