Department of Hepato-Gastroenterology, Erasme Hospital-Free University of Brussels, Route de Lennik, 808, 1070 Brussels, Belgium.
World J Gastroenterol. 2011 Nov 7;17(41):4590-5. doi: 10.3748/wjg.v17.i41.4590.
To investigate the potential benefit of Fujinon intelligent chromo endoscopy (FICE)-assisted small bowel capsule endoscopy (SBCE) for detection and characterization of small bowel lesions in patients with obscure gastroenterology bleeding (OGIB).
The SBCE examinations (Pillcam SB2, Given Imaging Ltd) were retrospectively analyzed by two GI fellows (observers) with and without FICE enhancement. Randomization was such that a fellow did not assess the same examination with and without FICE enhancement. The senior consultant described findings as P0, P1 and P2 lesions (non-pathological, intermediate bleed potential, high bleed potential), which were considered as reference findings.
Inter-observer correlation was calculated using kappa statistics. Sensitivity and specificity for P2 lesions was calculated for FICE and white light SBCE.
In 60 patients, the intra-class kappa correlations between the observers and reference findings were 0.88 and 0.92 (P2), 0.61 and 0.79 (P1), for SBCE using FICE and white light, respectively. Overall 157 lesions were diagnosed using FICE as compared to 114 with white light SBCE (P = 0.15). For P2 lesions, the sensitivity was 94% vs 97% and specificity was 95% vs 96% for FICE and white light, respectively. Five (P2 lesions) out of 55 arterio-venous malformations could be better characterized by FICE as compared to white light SBCE. Significantly more P0 lesions were diagnosed when FICE was used as compared to white light (39 vs 8, P < 0.001).
FICE was not better than white light for diagnosing and characterizing significant lesions on SBCE for OGIB. FICE detected significantly more non-pathological lesions. Nevertheless, some vascular lesions could be more accurately characterized with FICE as compared to white light SBCE.
探讨富士能智能染色内镜（FICE）辅助小肠胶囊内镜（SBCE）对不明原因胃肠道出血（OGIB）患者小肠病变的检测和特征分析的潜在益处。
对 60 例接受 SBCE 检查（Pillcam SB2，Given Imaging Ltd）的患者进行回顾性分析，由两名胃肠病学研究员（观察者）分别在 FICE 增强和非增强条件下进行评估。随机分配方式使得一名研究员不会同时评估 FICE 增强和非增强条件下的同一检查。高级顾问将发现描述为 P0、P1 和 P2 病变（非病理性、中度出血潜能、高度出血潜能），这些病变被视为参考发现。
采用 Kappa 统计计算观察者之间的相关性。计算 FICE 和白光 SBCE 对 P2 病变的敏感性和特异性。
在 60 例患者中，观察者与参考发现之间的内类 Kappa 相关性分别为 0.88 和 0.92（P2）、0.61 和 0.79（P1），用于 FICE 和白光 SBCE。与白光 SBCE 相比，FICE 共诊断出 157 个病变，而白光 SBCE 则诊断出 114 个病变（P=0.15）。对于 P2 病变，FICE 的敏感性为 94%，特异性为 95%，白光 SBCE 的敏感性为 97%，特异性为 96%。与白光 SBCE 相比，FICE 可以更好地对 5 个（P2 病变）动静脉畸形进行特征分析。与白光 SBCE 相比，使用 FICE 时可诊断出更多的 P0 病变（39 个 vs 8 个，P<0.001）。
与白光 SBCE 相比，FICE 对 OGIB 患者的 SBCE 诊断和特征分析并不更优。FICE 检测到的非病理性病变明显更多。然而，与白光 SBCE 相比，FICE 可以更准确地对一些血管病变进行特征分析。
