Barbeiro Sandra, Libânio Diogo, Castro Rui, Dinis-Ribeiro Mário, Pimentel-Nunes Pedro
Department of Gastroenterology, Centro Hospitalar de Leiria, Leiria, Portugal.
Department of Gastroenterology, Instituto Português de Oncologia do Porto, Porto, Portugal.
GE Port J Gastroenterol. 2018 Dec;26(1):40-53. doi: 10.1159/000487470. Epub 2018 Mar 27.
Narrow-band imaging is an advanced imaging system that applies optic digital methods to enhance endoscopic images and improves visualization of the mucosal surface architecture and microvascular pattern. Narrow-band imaging use has been suggested to be an important adjunctive tool to white-light endoscopy to improve the detection of lesions in the digestive tract. Importantly, it also allows the distinction between benign and malignant lesions, targeting biopsies, prediction of the risk of invasive cancer, delimitation of resection margins, and identification of residual neoplasia in a scar. Thus, in expert hands it is a useful tool that enables the physician to decide on the best treatment (endoscopic or surgical) and management. Current evidence suggests that it should be used routinely for patients at increased risk for digestive neoplastic lesions and could become the standard of care in the near future, at least in referral centers. However, adequate training programs to promote the implementation of narrow-band imaging in daily clinical practice are needed. In this review, we summarize the current scientific evidence on the clinical usefulness of narrow-band imaging in the diagnosis and characterization of digestive tract lesions/cancers and describe the available classification systems.
窄带成像(NBI)是一种先进的成像系统,它采用光学数字方法来增强内镜图像,并改善黏膜表面结构和微血管形态的可视化。窄带成像已被认为是白光内镜检查的一种重要辅助工具,可用于提高消化道病变的检测率。重要的是,它还能够区分良性和恶性病变,指导活检,预测浸润性癌症的风险,界定切除边缘,并识别瘢痕中的残留肿瘤。因此,在专家手中,它是一种有用的工具,能使医生决定最佳的治疗方案(内镜治疗或手术治疗)和管理方式。目前的证据表明,对于消化道肿瘤性病变风险增加的患者应常规使用窄带成像,并且在不久的将来,至少在转诊中心,它可能会成为标准的诊疗方法。然而,需要有适当的培训计划来促进窄带成像在日常临床实践中的应用。在这篇综述中,我们总结了当前关于窄带成像在消化道病变/癌症诊断和特征描述方面临床实用性的科学证据,并描述了现有的分类系统。