Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Dig Dis Sci. 2011 Mar;56(3):805-11. doi: 10.1007/s10620-010-1371-6. Epub 2010 Sep 16.
The degree of villous atrophy in celiac disease is difficult to assess at endoscopy. We sought to develop a quantitative technique for the evaluation of villous atrophy in endoscopic images.
In ten celiac patients as identified by standard endoscopy with biopsy, and ten control patients, standard and videocapsule endoscopic images of the duodenum were digitized. Subimages 7.5 × 7.5 mm(2) in area from random locations within each image were assessed by measuring the length of mucosal fissures per unit area (L), and correlating L with the histologic grade of villous atrophy as determined by modified Marsh criteria.
Mean L values for standard endoscopic images were 37.8, 43.3, 64.1, and 83.5 mm for Marsh grades II, IIIa, IIIb, and IIIc, respectively. Mean L values for videocapsule images were 49.1, 50.0, 64.7, and 72.4 mm for Marsh grades II, IIIa, IIIb, and IIIc, respectively. Significant differences in the means existed between celiac images (Marsh scores II-IIIc) versus controls (p < 0.001) for both endoscopic and videocapsule images. There were no significant differences between measurements obtained from endoscopic versus videocapsule images.
Quantified image analysis correlates with the histologic grade of villous atrophy, is automated, and lacks observer bias, thus lending itself to standardization.
在胃镜检查中，很难评估乳糜泻的绒毛萎缩程度。我们试图开发一种用于评估内镜图像中绒毛萎缩的定量技术。
在 10 例经标准内镜活检诊断为乳糜泻的患者和 10 例对照患者中，对十二指肠的标准和胶囊内镜图像进行数字化。从每个图像的随机位置测量单位面积内的黏膜裂隙长度（L），并将 L 与改良 Marsh 标准确定的组织学绒毛萎缩程度进行相关分析。
标准内镜图像的平均 L 值分别为 Marsh 分级 II、IIIa、IIIb 和 IIIc 的 37.8、43.3、64.1 和 83.5mm。胶囊内镜图像的平均 L 值分别为 Marsh 分级 II、IIIa、IIIb 和 IIIc 的 49.1、50.0、64.7 和 72.4mm。乳糜泻图像（Marsh 评分 II-IIIc）与对照组（p<0.001）的内镜和胶囊内镜图像的平均值之间存在显著差异。内镜和胶囊内镜图像的测量值之间无显著差异。
量化图像分析与组织学绒毛萎缩程度相关，是自动化的，并且缺乏观察者偏差，因此易于标准化。
