Department of Gastroenterology, Hepatology and Metabolic Diseases, University Hospital Aachen, D-52074 Aachen, Germany.
Endoscopy. 2010 Jan;42(1):22-7. doi: 10.1055/s-0029-1215268. Epub 2009 Nov 6.
Narrow-band imaging (NBI) has been developed as a new technique to differentiate tissue patterns in vivo. The aim of this study was to evaluate the diagnostic accuracy of NBI endoscopy with and without high magnification for the differentiation of neoplastic from non-neoplastic colorectal polyps.
Among 200 colorectal polyps from 131 patients, 100 lesions were classified according to vascular patterns by NBI endoscopy with high optical magnification and 100 lesions by high-definition endoscopy without high magnification. Additionally, the clarity of the vessel network was assessed. Histologic analysis was performed on all lesions.
NBI endoscopy with high magnification resulted in a sensitivity of 92.1 % and a specificity of 89.2 % for the differentiation of neoplastic versus non-neoplastic lesions. This performance was statistically comparable to high-definition NBI endoscopy without high magnification, which showed a sensitivity of 87.9 % and specificity of 90.5 %. However, vessel network was significantly better visualized by NBI endoscopy with optical magnification compared with high-definition NBI endoscopy without high magnification. In comparison with NBI endoscopy, white-light endoscopy, with or without magnification, resulted in inferior discrimination between neoplastic and non-neoplastic polyps.
The results demonstrate that the superior visibility of capillary vessels by the NBI technique allows the evaluation of colorectal lesions - based on the vascular patterns - with high diagnostic accuracy. In clinical routine, high-definition NBI endoscopy without high magnification may be used to sufficiently predict colorectal polyp histology, and high magnification can additionally facilitate visualization of vascular networks.
窄带成像（NBI）已被开发为一种新技术，用于区分体内组织模式。本研究旨在评估 NBI 内镜结合和不结合高倍放大对区分结直肠腺瘤性和非腺瘤性息肉的诊断准确性。
在 131 例患者的 200 个结直肠息肉中，100 个病变根据 NBI 内镜高倍放大下的血管模式进行分类，100 个病变根据高清内镜不高倍放大进行分类。此外，还评估了血管网络的清晰度。对所有病变进行组织学分析。
NBI 内镜高倍放大对区分肿瘤性和非肿瘤性病变的敏感性为 92.1%，特异性为 89.2%。这一表现与高清 NBI 内镜不高倍放大相当，其敏感性为 87.9%，特异性为 90.5%。然而，与高清 NBI 内镜不高倍放大相比，NBI 内镜高倍放大下的血管网络显示明显更好。与 NBI 内镜相比，白光内镜（有或无放大）在区分肿瘤性和非肿瘤性息肉方面的效果较差。
这些结果表明，NBI 技术对毛细血管的更好可视性使得能够基于血管模式对结直肠病变进行评估，具有较高的诊断准确性。在临床常规中，高清 NBI 内镜不高倍放大可能足以预测结直肠息肉的组织学特征，而高倍放大则可以更好地显示血管网络。
