Furuichi Yoshihiro, Abe Masakazu, Takeuchi Hirohito, Yoshimasu Yuu, Itoi Takao
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Department of Gastroenterology, Niiza Shiki Central General Hospital, Saitama, Japan.
Dig Endosc. 2022 Jan;34(1):87-95. doi: 10.1111/den.14011. Epub 2021 Jun 17.
Red dichromatic imaging (RDI) is a novel image-enhanced endoscopy released in 2020, which increases the visibility of deeper vessels. In this study, we retrospectively investigated whether RDI can shorten treatment times of endoscopic injection sclerotherapy (EIS), and which operational procedure times are affected compared with white light imaging (WLI).
A total of 155 patients (RDI, 70; WLI, 85) with risky esophageal varices (EV), who were treated with EIS were analyzed. Treatment times were compared, and predictors associated with treatment time were analyzed by multivariate analysis. For 24 cases (RDI, 12; WLI, 12) in which treatment videos were recorded, the procedure times of each step (observation of EV, needle flush, positioning, puncture, observation of bleeding, hemostasis, observation after hemostasis) were measured. Regarding the seven patients with EV bleeding, color differences were calculated between the bleeding point and the blood pool using the CIE (Lab*) color measurement method, and results were compared between using RDI and WLI.
Treatment times were shorter in the RDI group (RDI vs. WLI = 35.1 vs. 42.2 min; P < 0.01). 'RDI function' and 'amount of sclerosant' were extracted as independent predictors of treatment time. Times for 'observation of EV' and 'observation of bleeding' were shorter in the RDI group (P = 0.01 and <0.01, respectively). Regarding the color difference, RDI significantly increased bleeding point visibility (RDI vs. WLI = 31.4 ± 11.8 vs. 8.6 ± 6.2, P < 0.001).
Red dichromatic imaging can shorten the treatment time of EIS by increasing bleeding point visibility.
红色双色成像（RDI）是2020年推出的一种新型图像增强型内镜检查，可提高深部血管的可视性。在本研究中，我们回顾性调查了RDI是否能缩短内镜注射硬化治疗（EIS）的治疗时间，以及与白光成像（WLI）相比，哪些操作步骤时间会受到影响。
分析了155例接受EIS治疗的高危食管静脉曲张（EV）患者（RDI组70例；WLI组85例）。比较治疗时间，并通过多变量分析分析与治疗时间相关的预测因素。对于记录了治疗视频的24例患者（RDI组12例；WLI组12例），测量了每个步骤（观察EV、针头冲洗、定位、穿刺、观察出血、止血、止血后观察）的操作时间。对于7例EV出血患者，使用CIE（Lab*）颜色测量方法计算出血点与血池之间的颜色差异，并比较RDI和WLI的结果。
RDI组的治疗时间较短（RDI与WLI分别为35.1分钟和42.2分钟；P<0.01）。“RDI功能”和“硬化剂用量”被确定为治疗时间的独立预测因素。RDI组的“观察EV”和“观察出血”时间较短（分别为P=0.01和<0.01）。关于颜色差异，RDI显著提高了出血点的可视性（RDI与WLI分别为31.4±11.8和8.6±6.2，P<0.001）。
红色双色成像可通过提高出血点可视性缩短EIS的治疗时间。
