光学增强内镜(OE)对胃肠上皮化生准确性研究  

Accuracy of Gastrointestinal Epithelial Metaplasia Detected by Optical Enhanced Endoscopy(OE)

作　　者：王立梅 刘晗[1] WANG Li-mei;LIU Han(Department of Gastroenterology,Qilu Hospital of Shandong University,Shandong Jinan 250012)

机构地区：[1]山东大学齐鲁医院消化内科,山东济南250012

出　　处：《中国医疗器械信息》2022年第11期38-40,共3页China Medical Device Information

基　　金：国家自然科学基金资助项目(项目编号:81800462)。

摘　　要：目的:评估光学增强内镜(Optical Enhancement,OE)或OE联合放大内镜(放大OE)在胃肠上皮化生诊断中的临床应用价值。方法:选取2017年1月~2021年5月在山东大学齐鲁医院行放大内镜检查的患者135例,检查顺序为白光内镜-OE内镜-放大OE,分别根据病变的小凹结构及腺管开口和微血管清晰程度和可辨认程度进行量化评分。比较白光内镜与OE、放大OE图像清晰度。放大OE下分别记录每处病变亮蓝嵴(Light Blue Crest,LBC)、绒毛状结构(Villous Pattern,VP)、大长冠(Large Long Crest,LLC)情况,与病理学比较对GIM的诊断价值。结果:OE和放大OE评价图像清晰度优于白光内镜,差异具有统计学意义(P=0.001,P<0.001)。LBC、VP、LLC对诊断GIM的准确度分别为82.46%、76.02%、81.29%,并具有统计学意义(P<0.001)。同时满足三个特征诊断GIM准确度为94.74%。结论:在观察病变的清晰度方面,OE放大内镜显著优于OE和白光内镜,OE内镜优于白光内镜。LBC、VP、LLC是放大OE下胃肠上皮化生的特征性表现,内镜下符合三种特征的病变能准确诊断肠上皮化生,LBC诊断肠上皮化生的准确度优于VP和LLC。Objective: This study is aimed at comparing the differential diagnostic value of optical enhancement technology(OE)/magnifying optical enhancement technology(ME-OE) and white-light endoscopy(WLE) for gastric intestinal metaplasia(GIM). Methods: From January 2017 to May 2021, 135 patients who underwent ME-OE in Qilu Hospital of Shandong University were recruited. The examination sequence was WLE followed by OE and ME-OE. Image clarity scores were recorded according to the mucosal surface patterns and the microvascular patterns of lesions. Then to compare the image clarity between WLE, OE and ME-OE. According to the features of light blue crest(LBC), villous pattern(VP) and large long crest(LLC) observed by ME-OE, the diagnostic value of GIM was compared with pathology. Results: OE and magnified OE are superior to white light endoscopy in the evaluation of image sharpness, and the difference between them is statistically significant(P =0.001,P < 0.001). The accuracy of LBC, VP and LLC in diagnosis of GIM is 82.46%, 76.02% and 81.29%, and it’s statistically significant(P < 0.001). The accuracy of GIM diagnosis was 94.74% when the three characteristics were satisfied simultaneously. Conclusion: MEOE was superior to OE and WLE in the image clarify observation of each lesions. LBC, VP and LLC are characteristic manifestations for GIM diagnosis under ME-OE. The diagnostic value was satisfactory with all the 3 features, and the accuracy of LBC is superior to VP and LLC in the diagnosis of GIM.

关 键 词：光学增强内镜 胃肠上皮化生 亮蓝嵴 绒毛状结构 长冠状结构 

分 类 号：TH779[机械工程—仪器科学与技术]