Chavalitdhamrong D, Chen G C, Roth B E, Goltzer O, Sul J, Jutabha R
David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Dis Esophagus. 2011 Jul;24(5):295-8. doi: 10.1111/j.1442-2050.2010.01136.x. Epub 2011 Jun 10.
Esophageal capsule endoscopy (ECE) may offer an alternative approach to visualize esophageal lesions associated with gastroesophageal reflux (GER) disease. The objective of this study was to report the ECE findings in patients with GER symptoms and validate a new scoring system to assess ECE video quality. Five hundred two ECE were performed in patients with GER symptoms. We devised a new grading scale called ECE Utility score to assess the quality of images using five different parameters: anatomic landmarks visualized, esophageal transit time, image quality, illumination, and artifacts. The ECE cases were independently scored by two interpreters in a randomized, blinded fashion. Reflux esophagitis was diagnosed via ECE in 254 patients (50.5%). We identified 12 cases (2.4%) with suspected Barrett's esophagus and all of them had endoscopic evidence of Barrett's esophagus on esophagogastroduodenoscopy. Histologic confirmation Barrett's esophagus was found in six patients and dysplasia was found in one patient. From the 502 cases, mean ± standard deviation total ECE Utility score was 8.89 ± 0.96 for interpreter 1 and 8.96 ± 0.93 for interpreter 2. The concordance rate between the two interpreters for the ECE Utility score ranged from 75.9-96.8% across the parameters and the Pearson correlation rate of the total score was 0.81. ECE is shown to be a simple noninvasive valuable technique for evaluating esophageal mucosa and producing high quality images in patients with GER symptoms. ECE can help as an alternative screening tool for diagnosing Barrett's esophagus.
食管胶囊内镜检查（ECE）可能为可视化与胃食管反流（GER）病相关的食管病变提供一种替代方法。本研究的目的是报告GER症状患者的ECE检查结果，并验证一种评估ECE视频质量的新评分系统。对502例有GER症状的患者进行了ECE检查。我们设计了一种名为ECE效用评分的新分级量表，使用五个不同参数评估图像质量：可视的解剖标志、食管通过时间、图像质量、照明和伪像。两名解读人员以随机、盲法的方式对ECE病例进行独立评分。通过ECE诊断出254例（50.5%）反流性食管炎患者。我们确定了12例（2.4%）疑似巴雷特食管患者，所有这些患者在食管胃十二指肠镜检查中均有巴雷特食管的内镜证据。在6例患者中发现了巴雷特食管的组织学确诊，在1例患者中发现了发育异常。在这502例病例中，解读人员1的平均±标准差总ECE效用评分为8.89±0.96，解读人员2为8.96±0.93。两名解读人员对ECE效用评分的一致性率在各参数间为75.9 - 96.8%，总分的Pearson相关率为0.81。ECE被证明是一种简单、无创的有价值技术，可用于评估GER症状患者的食管黏膜并生成高质量图像。ECE可作为诊断巴雷特食管的一种替代筛查工具。
