Bolzán Héctor Emilio, Miravalle Daniela
Unidad de Endoscopía Digestiva, Provincia de Buenos Aires, Argentina.
Acta Gastroenterol Latinoam. 2013 Mar;43(1):12-5.
We used the immersion technique for the evaluation of duodenal mucosa for several years and we observed discordant results in relation to the literature.
To evaluate the immersion technique in the diagnosis of duodenal mucosa diseases.
We performed an upper endoscopy, immersion technique, chromoendoscopy and biopsies of the second portion of the duodenum to the patients who met the inclusion criteria. It was reported the presence of villi and the partial or total absence of them.
The standard endoscopy showed absence of villi in 16 patients and normal mucosa in 384. The comparison between these results and those of the biopsies showed that biopsies were normal in 3 patients with presumed absence of villi and had a partial atrophy of villi in 1 patient with normal endoscopy. With the immersion technique and the chromoendoscopy we observed absence of villi in 13 patients and normal mucosa in 386. When we compared these results with those of the biopsies, we observed that 1 normal patient had a partial atrophy of villi. These results indicate that standard endoscopy has a sensitivity of 92%, a specificity of 99%, a positive predictive value of 81% and a negative predictive value of 99%. The immersion technique and chromoendoscopy have a sensitivity of 92%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 99%.
In our experience the immersion technique does not improve the visualization of the villi compared with the standard endoscopy and the chromoendoscopy.
我们使用浸泡技术评估十二指肠黏膜数年，发现与文献结果不一致。
评估浸泡技术在十二指肠黏膜疾病诊断中的应用。
对符合纳入标准的患者进行十二指肠第二部的上消化道内镜检查、浸泡技术、色素内镜检查及活检。记录绒毛的存在情况以及绒毛部分或完全缺失的情况。
标准内镜检查显示16例患者无绒毛，384例患者黏膜正常。这些结果与活检结果对比显示，3例推测无绒毛的患者活检结果正常，1例内镜检查正常的患者存在绒毛部分萎缩。采用浸泡技术和色素内镜检查时，我们观察到13例患者无绒毛，386例患者黏膜正常。将这些结果与活检结果对比时，我们发现1例正常患者存在绒毛部分萎缩。这些结果表明，标准内镜检查的灵敏度为92%，特异度为99%，阳性预测值为81%，阴性预测值为99%。浸泡技术和色素内镜检查的灵敏度为92%，特异度为100%，阳性预测值为100%，阴性预测值为99%。
根据我们的经验，与标准内镜检查和色素内镜检查相比，浸泡技术并未改善绒毛的可视化效果。
