Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.
Endoscopy. 2019 Mar;51(3):237-243. doi: 10.1055/a-0755-7471. Epub 2019 Jan 15.
To improve detection of mucosal lesions during colonoscopy a number of imaging modalities have been suggested, including high definition and virtual chromoendoscopy. Given the theoretical advantage of these new imaging techniques, we aimed to investigate their use for the detection of polyps in patients referred for colonoscopy in a large tertiary hospital.
Demographic, endoscopic, and histological data from 1855 consecutive patients undergoing colonoscopy were collected prospectively. Patients were randomly assigned to three endoscopy systems (Fujinon, Olympus, or Pentax) in combination with four modalities: conventional white-light colonoscopy (n = 505), high definition white-light colonoscopy (n = 582), virtual chromoendoscopy (n = 285) and high definition virtual chromoendoscopy (n = 483).
The mean adenoma detection rate (ADR) was 34.9 %, and the adenoma per colonoscopy rate (APCR) was 2.1. No significant differences were noted between the three endoscopy systems. Moreover, no differences in ADR or APCR were observed between the four imaging modalities. High definition white-light colonoscopy resulted in a significantly higher detection of sessile serrated adenomas (8.2 % vs. 3.8 %; < 0.01) and adenocarcinomas (2.6 % vs. 0.5 %; < 0.05) compared with the conventional procedure.
No significant differences in ADR or APCR between different endoscopy systems, high definition, and/or virtual chromoendoscopy could be observed in routine colonoscopies in the general population. High definition endoscopy was associated with a significantly higher detection rate of serrated adenomas and adenocarcinomas.
为了提高结肠镜检查中黏膜病变的检出率，已经提出了多种成像方式，包括高清和虚拟染色内镜。鉴于这些新成像技术的理论优势，我们旨在研究它们在大型三级医院进行结肠镜检查的患者中对息肉的检测效果。
前瞻性收集了 1855 例连续接受结肠镜检查的患者的人口统计学、内镜和组织学数据。患者被随机分配到三个内镜系统（富士能、奥林巴斯或宾得），并结合四种模式：常规白光结肠镜检查（n=505）、高清白光结肠镜检查（n=582）、虚拟染色内镜检查（n=285）和高清虚拟染色内镜检查（n=483）。
平均腺瘤检出率（ADR）为 34.9%，腺瘤每例结肠镜检出率（APCR）为 2.1。三个内镜系统之间无显著差异。此外，四种成像模式之间的 ADR 或 APCR 也无差异。高清白光结肠镜检查显著提高了对平坦型锯齿状腺瘤（8.2%比 3.8%； ＜0.01）和腺癌（2.6%比 0.5%； ＜0.05）的检出率。
在一般人群的常规结肠镜检查中，不同内镜系统、高清和/或虚拟染色内镜之间的 ADR 或 APCR 无显著差异。高清内镜检查与锯齿状腺瘤和腺癌的检出率显著增加相关。
