FICE技术10组波长对大肠息肉的诊断价值

Value of Fuji intelligent chromo endoscopy under different channel settings in the diagnosis of colorectal polyps

目的:探讨FICE放大内镜10组波长组合对大肠息肉的观察效果,并选出最佳波长组合.方法:选择武汉大学人民医院2007-05/2010-05进行常规内镜检查,资料保存完整的大肠息肉患者378例.采用FICE放大技术预先设定的10组波长分别对病变进行腺管开口分型及毛细血管形态观察,并对图像清晰度进行评分,选出最佳波长组合,利用最佳波长组合判断病灶的性质,最终与病理结果相比较.结果:378例患者共发现大肠息肉432个.FICE放大内镜10组波长对病灶观察效果具有显著差异性(P<0.001),波长组合7(R=520nm,G=450nm,B=400nm)显示腺管开口优于其他波长组合(Rank%=25.73),在观察黏膜毛细血管形态结构方面波长4(R=520nm,G=500nm,B=405nm)优于其他波长组合(Rank%=25.76);二者结合与病理比较对病灶性质的判断符合率为95.6%,敏感性90.7%,特异性86.8%.结论:波长组合7及4分别对观察大肠息肉腺管开口和黏膜毛细血管效果较理想,且二者相结合可提高诊断符合率.

AIM： To determine the value of Fuji intelligent chromo endoscopy （FICE） under different channel settings in detecting colorectal polyps and to identify the best channel setting for imaging. METHODS： From May 2007 to May 2010, 378 patients with colorectal polyps were enrolled in the study. The patients underwent a magnifying FICE procedure under 10 channel settings. The pit pattern and capillary form of the lesions were examined, with 10 FICE images taken for each lesion. The results of endoscopic diagnosis were then compared with those of pathologic diagnosis. RESULTS： A total of 432 colorectal polyps were detected in 378 patients. Endoscopic images differed signifi cantly among 10 channel settings （P 0.001）. Channel 7 （red： 520; green： 450; blue： 400） provided signif icantly better image quality for the pit pattern （Rank% = 25.73）, while chan-nel 4 （red： 520; green： 500; blue： 405） was considered to be the best channel for observing the mucosal junction （Rank% = 25.76）. Combination of channel 7 and channel 4 images had a coinci- dence rate of 95.6% with pathological examination in the diagnosis of colorectal cancer, and the sensitivity and specif icity were 90.7% and 86.8%, respectively. CONCLUSION： FICE images differ signifi cantly among 10 channels settings in patients with colorectal polyps. Channel 7 provided significantly better image quality for the pit pattern, while channel 4 was considered to be the best channel for observing the mucosal junction.