Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
Gastrointest Endosc. 2012 Feb;75(2):405-10. doi: 10.1016/j.gie.2011.09.045.
The submucosal tunneling technique enables us to endoscopically access deeper tissue layers. Use of probe-based confocal laser endomicroscopy (pCLE) provides optical histologic imaging on the site.
To determine the technical feasibility of ex vivo and in vivo pCLE imaging of the muscularis propria and myenteric neurons by using submucosal endoscopy with a mucosal flap safety valve (SEMF).
Acute porcine model study.
Animal laboratory.
Two ex vivo and 6 in vivo porcine models were used. A submucosal space was created with SEMF, and a neuronal molecular probe was topically applied onto the muscularis. Confocal imaging of the stained muscularis was performed by using pCLE. The selected sites were sampled, and the histopathology of the sites was analyzed.
The two main outcome measures were the procedural success rate of submucosal access and the correlation between pCLE and histologic images.
Submucosal access to the pCLE study site was successful in all attempts (100%; 17/17 sites). The muscularis propria was visualized with pCLE in the ex vivo and in vivo porcine models in 83.3% of sites (20/24), and the neuron-like cells were identified in 41.7% of sites (10/24).
Animal experiment.
The muscularis propria and myenteric neurons could be selectively visualized with pCLE in vivo.
黏膜下隧道技术使我们能够在内镜下进入更深的组织层。使用基于探头的共聚焦激光内窥镜检查术（pCLE）可以在现场进行光学组织学成像。
确定使用黏膜下内镜与黏膜瓣安全阀（SEMF）进行黏膜下隧道内镜检查时对固有肌层和肌间神经元进行体外和体内 pCLE 成像的技术可行性。
急性猪模型研究。
动物实验室。
使用 SEMF 创建黏膜下空间，并将神经元分子探针局部应用于固有肌层。使用 pCLE 对染色的固有肌层进行共焦成像。选择部位进行取样，并分析部位的组织病理学。
两个主要观察指标是黏膜下通道建立的程序成功率和 pCLE 与组织学图像之间的相关性。
黏膜下通道建立到 pCLE 研究部位在所有尝试中均成功（100%；17/17 个部位）。在体外和体内猪模型中，pCLE 成功显示固有肌层的比例为 83.3%（20/24），识别神经元样细胞的比例为 41.7%（10/24）。
动物实验。
体内可以用 pCLE 选择性地观察固有肌层和肌间神经元。
