Itoi Takao, Neuhaus Horst, Chen Yang K
Department of Gastroenterology, Tokyo Medical University, Nishishinjuku 6-7-1, Shinjuku-ku, Tokyo 160-0023, Japan.
Gastrointest Endosc Clin N Am. 2009 Oct;19(4):557-66. doi: 10.1016/j.giec.2009.06.002.
We summarized past and present results concerning the observation capability of cholangiopancratoscopy using chromoendoscopy, autofluorescence imaging (AFI), and narrow-band imaging (NBI). New generation peroral and percutaneous transhepatic video cholangiopancreatoscopes provide superior quality images. Pilot studies suggest that chromoendocholangioscopy using methylene blue or cholangioscopy using AFI can distinguish benign from malignant bile duct lesions. On the other hand, the NBI system enhances the imaging of certain features such as mucosal structures and microvessels in pancreatobiliary lesions. In patients with main-duct-type intraductal papillary mucinous neoplasm, peroral pancreatoscopy can be used to determine extent of tumor involvement. Although many technical hurdles still need to be overcome, image-enhanced cholangiopancratoscopy appears to be a promising modality to improve diagnostic accuracy of pancreatobiliary diseases, particularly in distinguishing benign from malignant lesions.
我们总结了过去和目前有关使用染色内镜、自体荧光成像（AFI）和窄带成像（NBI）进行胆管胰管镜检查观察能力的结果。新一代经口和经皮经肝胆管胰管视频内镜可提供更高质量的图像。初步研究表明，使用亚甲蓝的染色胆管内镜检查或使用AFI的胆管内镜检查能够区分胆管良性和恶性病变。另一方面，NBI系统可增强对胰胆病变某些特征（如黏膜结构和微血管）的成像。对于主胰管型导管内乳头状黏液性肿瘤患者，经口胰管镜检查可用于确定肿瘤累及范围。尽管仍需克服许多技术障碍，但图像增强胆管胰管镜检查似乎是一种很有前景的方法，可提高胰胆疾病的诊断准确性，尤其是在区分良性和恶性病变方面。
