Polglase Adrian L, McLaren Wendy J, Delaney Peter M
Cabrini Monash University Department of Surgery, Suite 20, Isabella Street, Malvern, VIC 3144, Australia.
Expert Rev Med Devices. 2006 Sep;3(5):549-56. doi: 10.1586/17434440.3.5.549.
With advances in endoscopic imaging tools, it is becoming increasingly possible to find, assess and treat numerous gastrointestinal (GI) pathologies at the time of endoscopy. This article focuses on the newly developed Pentax confocal endomicroscope that enables in vivo microscopic imaging of the upper and lower GI tract in histological detail at the time of patient examination without the collection of biopsies. The optical imaging technique has the potential to revolutionize clinical workflows in endoscopy through high-resolution fluorescence imaging of cellular and subcellular detail from the surface and subepithelial layers of the GI mucosa. The device incorporates a full screen, high-resolution charge coupled device as well as a confocal microscope. Preliminary data from blinded clinical studies suggests that the use of this device can increase the diagnostic yield for disease detection in conditions such as ulcerative colitis and Barrett's esophagus, where diagnosis using white light endoscopy is problematic. The early detection and diagnosis of GI abnormalities through the collection of 'optical' biopsies or targeted mucosal excisional biopsies has the potential to improve patient outcomes and enable early therapeutic intervention.
随着内镜成像工具的进步，在内镜检查时发现、评估和治疗众多胃肠道（GI）病变变得越来越可能。本文重点介绍新开发的宾得共聚焦内镜显微镜，它能够在患者检查时对上下消化道进行体内微观成像，呈现组织学细节，而无需采集活检样本。这种光学成像技术有潜力通过对胃肠道黏膜表面和上皮下细胞及亚细胞细节进行高分辨率荧光成像，彻底改变内镜临床工作流程。该设备集成了全屏幕、高分辨率电荷耦合器件以及共聚焦显微镜。来自盲法临床研究的初步数据表明，在溃疡性结肠炎和巴雷特食管等疾病中，使用该设备可提高疾病检测的诊断率，而在这些疾病中，白光内镜诊断存在问题。通过采集“光学”活检样本或靶向黏膜切除活检样本对胃肠道异常进行早期检测和诊断，有可能改善患者预后并实现早期治疗干预。
