Ciaccio Edward J, Lewis Suzanne K, Bhagat Govind, Green Peter H
Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York, NY, USA.
Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
Ann Transl Med. 2017 May;5(9):197. doi: 10.21037/atm.2017.05.06.
Celiac disease is diagnosed in part by finding areas of pathology in the small bowel (SB) mucosa. This can often be difficult because the pathologic alterations, including atrophy of the small intestinal villi, can often be sparse and subtle. Some of the quantitative methods for detecting and measuring the presence of villous atrophy from videocapsule endoscopy (VCE) images are presented and discussed. These methods consist of static features of measurement including texture, gray level, and presence and abundance of fissures contained within each acquired image. The methods also consist of dynamic measurements including spectral analysis, and determining motion from a sequence of endoscopic images as obtained from a VCE clip. Thus far, several methods have been found useful to characterize the SB mucosa of untreated celiac disease patients versus control patients lacking villous atrophy, which have revealed significant differences in texture, frequency, and motion on analysis of VCE. In untreated celiac patients undergoing endoscopy, there tends to be greater magnitude of changes and spatial differences in textural descriptors, longer periodic components, indicating slower periodic activity, and differences in feature location, suggesting alterations in motility at areas of pathology as compared to patients without villous atrophy. Improvements in the quantitative analysis of VCE imaging in celiac patients is important to detect pathology in suspected patients, so that biopsies can be obtained from pertinent regions of the small intestinal mucosa. Improvements are also necessary so that patients with celiac disease can be monitored to evaluate the progress of mucosal healing after onset of treatment.
乳糜泻的诊断部分依赖于在小肠（SB）黏膜中发现病理区域。这通常具有一定难度，因为包括小肠绒毛萎缩在内的病理改变往往较为稀疏且细微。本文展示并讨论了一些从视频胶囊内镜（VCE）图像中检测和测量绒毛萎缩情况的定量方法。这些方法包括测量的静态特征，如纹理、灰度以及每个获取图像中所含裂隙的存在情况和丰富程度。方法还包括动态测量，如光谱分析，以及从VCE片段获得的一系列内镜图像中确定运动情况。到目前为止，已发现几种方法对于表征未经治疗的乳糜泻患者与缺乏绒毛萎缩的对照患者的小肠黏膜很有用，这些方法在对VCE的分析中揭示了纹理、频率和运动方面的显著差异。在接受内镜检查的未经治疗的乳糜泻患者中，与没有绒毛萎缩的患者相比，纹理描述符的变化幅度和空间差异往往更大，周期性成分更长，表明周期性活动较慢，且特征位置存在差异，这表明病理区域的运动性发生了改变。改进乳糜泻患者VCE成像的定量分析对于检测疑似患者的病理情况很重要，这样就可以从小肠黏膜的相关区域获取活检样本。改进也是必要的，以便对乳糜泻患者进行监测，以评估治疗开始后黏膜愈合的进展情况。
