Ussui Vivian, Xu Can, Crook Julia E, Diehl Nancy N, Hardee Joy, Staggs Estela G, Shahid Muhammad W, Wallace Michael B
Mayo Clinic in Florida, Jacksonville, Florida, United States.
Mayo Clinic in Florida, Jacksonville, Florida, United States ; Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Endosc Int Open. 2015 Oct;3(5):E516-22. doi: 10.1055/s-0034-1392233. Epub 2015 Jul 21.
Colorectal cancer can be prevented through the use of colonoscopy with polypectomy. Most colon polyps are benign or low grade adenomas. However, currently all lesions need histopathologic analysis, which increases diagnostic costs and delays the final diagnosis. Confocal laser endomicroscopy (CLE) is a new technology that enables real-time endomicroscopy. However, there are challenges to maintaining a stable image with currently available systems. We conducted a small study to obtain a preliminary assessment of whether the use of an endoscopic distal attachment cap may enhance image quality of CLE in comparison with images obtained with free-hand acquisition.
Forty outpatients underwent colonoscopy for evaluation of colon polyps in a single academic medical center. Patients were assigned randomly to 1 of 2 study arms on the basis of whether an endoscopic distal attachment cap was used (n = 21, Cap Used) or not used (n = 19, No Cap) in the procedure. The quality of confocal images and probe stabilization was summarized.
A total of 81 polyps were identified. The proportion of polyps with images of high quality was 74 % (28/38) in the Cap Used group and 79 % (30/38) in the No Cap arm. Image stability was also similar with and without a cap. Diagnostic accuracy was estimated to be slightly higher in the Cap Used group for probe-based confocal laser endomicroscopy (pCLE; 78 % vs 70 %). This was also true for white-light and narrow-band imaging.
This preliminary study did not yield any evidence to support that the use of an endoscopic distal attachment cap improves the quality of images obtained during CLE.
通过结肠镜检查并切除息肉可预防结直肠癌。大多数结肠息肉为良性或低级别腺瘤。然而，目前所有病变均需进行组织病理学分析，这增加了诊断成本并延迟了最终诊断。共聚焦激光内镜显微术（CLE）是一项能够实现实时内镜显微检查的新技术。然而，使用现有系统保持稳定图像存在挑战。我们开展了一项小型研究，以初步评估与徒手采集的图像相比，使用内镜远端附件帽是否可提高CLE的图像质量。
在一家学术医疗中心，40名门诊患者接受结肠镜检查以评估结肠息肉。根据操作过程中是否使用内镜远端附件帽，将患者随机分为2个研究组之一（使用帽组，n = 21；未使用帽组，n = 19）。总结共聚焦图像的质量和探头稳定性。
共识别出81个息肉。使用帽组中高质量图像的息肉比例为74%（28/38），未使用帽组为79%（30/38）。有无帽时图像稳定性也相似。基于探头的共聚焦激光内镜显微术（pCLE）的诊断准确性在使用帽组估计略高（78%对70%）。白光和窄带成像也是如此。
这项初步研究未获得任何证据支持使用内镜远端附件帽可提高CLE期间获得的图像质量。
