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2.
Dig Dis Sci ; 58(5): 1287-92, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23108566

RESUMO

BACKGROUND: I-scan technology is the newly developed endoscopic tool that works in real time and utilizes a digital contrast method to enhance endoscopic image. AIMS: We performed a feasibility study aimed to determine the diagnostic accuracy of i-scan technology for the evaluation of duodenal villous patterns, having histology as the reference standard. METHODS: In this prospective, single center, open study, patients undergoing upper endoscopy for an histological evaluation of duodenal mucosa were enrolled. All patients underwent upper endoscopy using high resolution view in association with i-scan technology. During endoscopy, duodenal villous patterns were evaluated and classified as normal, partial villous atrophy, or marked villous atrophy. Results were then compared with histology. RESULTS: One hundred fifteen subjects were recruited in this study. The endoscopist was able to find marked villous atrophy of the duodenum in 12 subjects, partial villous atrophy in 25, and normal villi in the remaining 78 individuals. The i-scan system was demonstrated to have great accuracy (100 %) in the detection of marked villous atrophy patterns. I-scan technology showed quite lower accuracy in determining partial villous atrophy or normal villous patterns (respectively, 90 % for both items). CONCLUSIONS: Image-enhancing endoscopic technology allows a clear visualization of villous patterns in the duodenum. By switching from the standard to the i-scan view, it is possible to optimize the accuracy of endoscopy in recognizing villous alteration in subjects undergoing endoscopic evaluation.


Assuntos
Doença Celíaca/diagnóstico , Duodenoscopia , Aumento da Imagem , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Enteropatias/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
4.
J Clin Gastroenterol ; 43(3): 244-8, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18813029

RESUMO

GOALS: We investigated the learning parameters of the immersion technique for the assessment of marked villous atrophy (MVA), during routine esophagogastroduodenoscopy (EGD). BACKGROUND: The immersion technique offers a proven possibility of enhancing the sensitivity of endoscopy in detecting duodenal villous atrophy patterns. STUDY: Nine endoscopists with at least 2 years of experience, who had previously been trained to perform the immersion technique, searched for duodenal villi during routine EGD. In a 2-year study, duodenal villi were evaluated underwater duodenoscopy in 432 patients from whom duodenal biopsies had been, for various reasons, obtained. The endoscopic findings were compared with the histology. The learning parameters of the water immersion technique and the accuracy in detecting subjects with MVA were observed. RESULTS: A total of 28 (6.5%) patients with MVA were identified during endoscopy by the trained endoscopists. All these patients were diagnosed as being celiac patients. The sensitivity, specificity, and accuracy (positive and negative predictive values) of the immersion technique in detecting MVA patterns, irrespective of the endoscopist who performed the examination, were always 100%. CONCLUSIONS: The underwater evaluation of the duodenum can be efficiently and regularly performed during routine EGD by endoscopists with 2 years of experience, after a specific, brief training period. This procedure is simple, feasible, and can accurately detect MVA patterns.


Assuntos
Doença Celíaca/diagnóstico , Competência Clínica , Duodenoscopia/métodos , Duodeno/patologia , Adolescente , Adulto , Idoso , Atrofia/diagnóstico , Atrofia/patologia , Doença Celíaca/patologia , Duodenoscopia/normas , Duodeno/ultraestrutura , Feminino , Gastroenterologia/educação , Humanos , Imersão , Masculino , Microvilosidades/patologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Água , Adulto Jovem
5.
Gastrointest Endosc ; 68(2): 352-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18547574

RESUMO

BACKGROUND: The optimal band imaging (OBI) system is a new technology that can select better spectral images decomposed from ordinary endoscopic images. This technology, first introduced as "FUJI Intelligent Color Enhancement," enhances the contrast of the mucosal surface without the use of dyes. OBJECTIVE: This study aimed to evaluate the potential of OBI for predicting the duodenal villous morphologic characteristics in patients with suspected celiac disease. DESIGN: This study was designed as an open, prospective, single-center trial. Duodenoscopy was performed with a high-resolution magnification view, in association with OBI spectral processing. Duodenal villous patterns were evaluated and classified as normal, partially atrophic, or markedly atrophic. The endoscopic results were then compared with the histologic diagnosis. SETTING: Endoscopy unit at the A. Gemelli University Hospital of Rome, Italy. PATIENTS: Sixty-one patients undergoing upper endoscopy for clinical history of malabsorption or serologic suspicion for celiac disease were included in the study. RESULTS: From OBI sets using red, green, and blue wavelength combinations that ranged from 400 to 580 nm, the endoscopist was able to find marked villous atrophy of the duodenum in 16 subjects, partial villous atrophy in 9 subjects, and normal villi in the remaining 36 subjects. The sensitivity, specificity, and positive and negative predictive values of the OBI-based duodenoscopy were 100% accurate in the evaluation of villous patterns. CONCLUSIONS: High-resolution magnification endoscopy with OBI allows clear visualization of the duodenal villous pattern. The OBI system may play a potential role in optimizing the diagnostic accuracy of endoscopy in celiac disease.


Assuntos
Doença Celíaca/patologia , Duodenoscópios , Duodenoscopia/métodos , Aumento da Imagem/métodos , Mucosa Intestinal/patologia , Adolescente , Adulto , Idoso , Atrofia/patologia , Biópsia por Agulha , Doença Celíaca/diagnóstico , Corantes , Meios de Contraste/farmacologia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Microvilosidades/patologia , Microvilosidades/ultraestrutura , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade
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