Improved bowel preparation increases polyp detection and unmasks significant polyp miss rate

AIM: To retrospectively compare previous-day vs splitdose preparation in terms of bowel cleanliness and polyp detection in patients referred for polypectomy. METHODS: Fifty patients underwent two colonoscopies: one diagnostic in a private clinic and a second for polypectomy in a University Hospital. The latter procedures were performed within 12 wk of the index ones. Examinations were accomplished by two experienced endoscopists, different in each facility. Twenty-seven patients underwent screening/surveillance colonoscopy, while the rest were symptomatic. Previous day bowel preparation was utilized initially and splitdose for polypectomy. Colon cleansing was evaluated using the Aronchick scale. We measured the number of detected polyps, and the polyp miss rates per-polyp.RESULTS: Excellent/good preparation was reported in 38 cases with previous-day preparation(76%) vs 46 with split-dose(92%), respectively(P = 0.03). One hundred and twenty-six polyps were detected initially and 169 subsequently(P < 0.0001); 88 vs 126 polyps were diminutive(P < 0.0001), 25 vs 29 small(P = 0.048) and 13 vs 14 equal or larger than 10 mm. The miss rates for total, diminutive, small and large polyps were 25.4%, 30.1%, 13.7% and 6.6%, respectively. Multivariate analysis revealed that split-dose preparation was significantly associated(OR, P) with increased number of polyps detected overall(0.869, P < 0.001), in the right(0.418, P = 0.008) and in the left colon(0.452, P = 0.02). CONCLUSION: Split-dose preparation improved colon cleansing, enhanced polyp detection and unmasked significant polyp miss rates.

Establishment and validation of a computer-assisted colonic polyp localization system based on deep learning

BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.

Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas

AIM To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type.METHODS This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer(CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma(A), one proximal adenoma(PA), one distal adenoma(DA), and one proximal serrated polyp(PSP) was assessed by using multilevel logistic regression models.RESULTS The observed detection rates among the 18 endoscopists ranged from 24.6% to 47.6%(mean = 35.7%) for A, from 19.1% to 39.0%(mean = 29.4%) for DA, from 6.0% to 22.9%(mean = 12.4%) for PA, and from 1.3% to 19.3%(mean = 6.9%) for PSP.After adjusting for patient-level variables(sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA(P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA(6.6%) compared with A(2.1%), and twofold higher for PSP(12.3%) compared with PA.CONCLUSION These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated p o l y p s, b u t n o t f o r d i s t a l a d e n o m a d e t e c t i o n. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure.

Polyp detection rate and pathological features in patients undergoing a comprehensive colonoscopy screening

AIMTo identify the prevalence, and clinical and pathologic characteristic of colonic polyps among Iranian patients undergoing a comprehensive colonoscopy, and determine the polyp detection rate (PDR) and adenoma detection rate (ADR). METHODSIn this cross-sectional study, demographics and epidemiologic characteristics of 531 persons who underwent colonoscopies between 2014 and 2015 at Mehrad gastrointestinal clinic were determined. Demographics, indication for colonoscopy, colonoscopy findings, number of polyps, and histopathological characteristics of the polyps were examined for each person. RESULTSOur sample included 295 (55.6%) women and 236 (44.4%) men, with a mean age of 50.25 ± 14.89 years. Overall PDR was 23.5% (125/531). ADR and colorectal cancer detection rate in this study were 12.8% and 1.5%, respectively. Polyps were detected more significantly frequently in men than in women (52.8% vs 47.2%, P vs 56.4 years, P CONCLUSIONThe prevalence of polyps and adenomas in this study is less than that reported in the Western populations. In our patients, distal colon is more susceptible to developing polyps and cancer than proximal colon.

Short turn radius colonoscope in an anatomical model: Retroflexed withdrawal and detection of hidden polyps

AIM: To evaluate the new Retro View^(TM) colonoscope and compare its ability to detect simulated polyps "hidden" behind colonic folds with that of a conventional colonoscope, utilizing anatomic colon models.METHODS: Three anatomic colon models were prepared,with twelve simulated polyps "hidden" behind haustral folds and five placed in easily viewed locations in each model. Five blinded endoscopists examined two colon models in random order with the conventional or Retro View^(TM) colonoscope, utilizing standard withdrawal technique. The third colon model was then examined with the Retro View^(TM) colonoscope withdrawn initially in retroflexion and then in standard withdrawal. Polyp detection rates during standard and retroflexed withdrawal of the conventional and Retro View^(TM) colonoscopes were determined. Polyp detection rates for combined standard and retroflexed withdrawal(combination withdrawal) with the Retro View^(TM) colonoscope were also determined.RESULTS: For hidden polyps, retroflexed withdrawal using the Retro View^(TM) colonoscope detected more polyps than the conventional colonoscope in standard withdrawal(85% vs 12%, P = 0.0001). For hidden polyps, combination withdrawal with the Retro View^(TM) colonoscope detected more polyps than the conventional colonoscope in standard withdrawal(93% vs 12%, P ≤ 0.0001). The Retro View^(TM) colonoscope in "combination withdrawal" was superior to other methods in detecting all(hidden + easily visible) polyps, with successful detection of 80 of 85 polyps(94%) compared to 28(32%) polyps detected by the conventional colonoscope in standard withdrawal(P < 0.0001) and 67(79%) polyps detected by the Retro View^(TM) colonoscope in retroflexed withdrawal alone(P < 0.01). Continuous withdrawal of the colonoscope through the colon model while retroflexed was achieved by all endoscopists. In a post-test survey, four out of five colonoscopists reported that manipulation of the colonoscope was easy or very easy.CONCLUSION: In simulated testing, the Retro View^(TM) colonoscope increased detection of hidden polyps. Combining standard withdrawal with retroflexed withdrawal may become the new paradigm for "complete screening colonoscopy".

Does hyoscine butylbromide really improve polyp detection during colonoscopy? A meta-analysis of randomized controlled trials

AIM: To investigate the benefits of hyoscine butylbromide in polyp detection during colonoscopy by a meta-analysis of available randomized controlled trials (RCTs).

High resolution colonoscopy in a bowel cancer screening program improves polyp detection

AIM： To compare high resolution colonoscopy （Olympus Lucera） with a megapixel high resolution system （Pentax HiLine） as an in-service evaluation. METHODS： Polyp detection rates and measures of performance were collected for 269 colonoscopy procedures. Five colonoscopists conducted the study over a three month period, as part of the United Kingdom bowel cancer screening program. RESULTS：There were no differences in procedure duration （x^2 p = 0.98）, caecal intubation rates （x^2 P = 0.67）, or depth of sedation （x^2 P = 0.64）. Mild discomfort was more common in the Pentax group （x^2 p = 0.036）. Adenoma detection rate was significantly higher in the Pentax group （x^2 test for trend P = 0.01）. Most of the extra polyps detected were flat or sessile adenomas. CONCLUSION： Megapixel definition colonoscopes improve adenoma detection without compromising other measures of endoscope performance. Increased polyp detection rates may improve future outcomes in bowel cancer screening programs.

Colonoscopy procedural volume increases adenoma and polyp detection rates in gastroenterology trainees

AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroenterologists.METHODS We reviewed colonoscopies from July 1, 2009 to June 30, 2014. Fellows' procedural logs were used to retrieve colonoscopy procedural volumes, and these were treated as the time variable. Findings from screening colonoscopies were used to calculate colonoscopy outcomes for each fellow for the prior 50 colonoscopies at each time point. ADR and PDR were plotted against colonoscopy procedural volumes to produce individual longitudinal graphs. Repeated measures linear mixed effects models were used to study the change of ADR and PDR with increasing procedural volume.RESULTS During the study period, 12 fellows completed full three years of training and were included in the analysis. The average ADR and PDR were, respectively, 31.5% and 41.9% for all fellows, and 28.9% and 38.2% for attendings alone. There was a statistically significant increase in ADR with increasing procedural volume(1.8%/100 colonoscopies, P = 0.002). Similarly, PDR increased 2.8%/100 colonoscopies(P = 0.0001), while there was no significant change in advanced ADR(0.04%/100 colonoscopies, P = 0.92). The ADR increase was limited to the right side of the colon, while the PDR increased in both the right and left colon. The adenoma per colon and polyp per colon also increased throughout training. Fellows reached the attendings' ADR and PDR after 265 and 292 colonoscopies, respectively.CONCLUSION We found that the ADR and PDR increase with increasing colonoscopy volume throughout fellowship. Our findings support recent recommendations of ≥ 275 colonoscopies for colonoscopy credentialing.

A Polyp Detection Method Based on FBnet

The incidence of colorectal cancer(CRC)in China has increased in recent years.The mortality rate of CRC has become one of the highest among all cancers;CRC increasingly affects the health and quality of people’s lives.However,due to the insufficiency of medical resources in China,the workload on medical doctors has further increased.In the past few decades,the adult CRC mortality and morbidity rate dropped sharply,mainly because of CRC screening and removal of adenomatous polyps.However,due to the differences in polyp itself and the skills of endoscopists,the detection rate of polyps varies greatly.In this paper,we adopt an anchor-free mechanism and introduce a better method to factorize the process of bounding box regression.Firstly,we regress the shape of object by the variant of Faster RCNN.Secondly,we re-define the target function of the location of object.The experimental result shows that our method achieves a mAP of 55.8%,which outperforms other state-of-the-art methods by at least 11.9%.This will greatly help to reduce the missed diagnosis of clinicians during endoscopy and treatment,and provide effective help for early diagnosis,early treatment and prevention of CRC.

Simple colonoscopy reporting system checking the detection rate of colon polyps

AIM: To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps.METHODS: A simple colonoscopy reporting system Kosin Gastroenterology(KG quality reporting system) was developed. The polyp detection rate(PDR),adenoma detection rate(ADR),serrated polyp detection rate(SDR),and advanced adenoma detection rate(AADR) are easily calculated to use this system.RESULTS: In our gastroenterology center,the PDR,ADR,SDR,and AADR test results from each gastroenterologist were updated,every month. Between June 2014,when the program was started,and December 2014,the overall PDR and ADR in our center were 62.5% and 41.4%,respectively. And the overall SDR and AADR were 7.5% and 12.1%,respectively.CONCLUSION: We envision that KG quality reporting system can be applied to develop a comprehensive system to check colon polyp detection rates in other gastroenterology centers.

Hyoscine for polyp detection during colonoscopy: A meta-analysis and systematic review

AIM: To assess the role of hyoscine for polyp detectionduring colonoscopy.METHODS: Studies(randomized controlled trials orRCTs) that compared the use of hyoscine vs no hyo-scine or placebo for polyp detection during colonoscopywere included in our analysis. A search on multiple da-tabases was performed in September 2013 with searchterms being "hyoscine and colonoscopy", "hyoscineand polyp", "hyoscine and adenoma", "antispasmoticand colonoscopy", "antispasmotic and adenoma", and"antispasmotic and polyp". Jadad scoring was used toassess the quality of studies. The efficacy of hyoscinewas analyzed using Mantel-Haenszel model for polypand adenoma detection with odds ratio(OR). The I2measure of inconsistency was used to assess hetero-geneity(P < 0.05 or I2 > 50%). Statistical analysis was performed by RevMan 5.1. Funnel plots was used to assess publication bias.RESULTS: The search of the electronic databases identified 283 articles. Of these articles, eight published RCTs performed at various locations in Europe, Asia, and Australia were included in our meta-analysis, seven published as manuscripts and one published as an ab-stract(n = 2307). All the studies included patients with a hyoscine and a no hyoscine/placebo group and were of adequate quality(Jadad score ≥ 2). Eight RCTs as-sessed the polyp detection rate(PDR)(n = 2307). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for PDR(OR = 1.06; 95%CI: 0.89-1.25; P = 0.51). Five RCTs assessed the adenoma detection rate(ADR)(n = 2015). The use of hyoscine demonstrated no statisti-cally significant difference as compared to no hyoscine or placebo for ADR(OR = 1.12; 95%CI: 0.92-1.37; P = 0.25). Furthermore, the timing of hyoscine admin-istration(given at cecal intubation or pre-procedure) demonstrated no differences in PDR compared to no hyoscine or placebo. Publication bias or heterogeneity was not observed for any of the outcomes.CONCLUSION: Hyoscine use in patients undergoing colonoscopy does not appear to significantly increase the detection of polyps or adenomas.

Association of trainee participation with adenoma and polyp detection rates

To investigate whether adenoma and polyp detection rates (ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODSWe performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparation quality. RESULTSA total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7% (P = 0.001), and for third year fellows it was 35.4% vs 30.7% (aOR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1% (P = 0.0003) and 45.7% vs 40.1% (aOR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level (P for trend < 0.05). CONCLUSIONThere is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection.

Artificial intelligence in polyp detection-where are we and where are we headed?

The goal of artificial intelligence in colonoscopy is to improve adenoma detection rate and reduce interval colorectal cancer.Artificial intelligence in polyp detection during colonoscopy has evolved tremendously over the last decade mainly due to the implementation of neural networks.Computer aided detection(CADe)utilizing neural networks allows real time detection of polyps and adenomas.Current CADe systems are built in single centers by multidisciplinary teams and have only been utilized in limited clinical research studies.We review the most recent prospective randomized controlled trials here.These randomized control trials,both non-blinded and blinded,demonstrated increase in adenoma and polyp detection rates when endoscopists used CADe systems vs standard high definition colonoscopes.Increase of polyps and adenomas detected were mainly small and sessile in nature.CADe systems were found to be safe with little added time to the overall procedure.Results are promising as more CADe have shown to have ability to increase accuracy and improve quality of colonoscopy.Overall limitations included selection bias as all trials built and utilized different CADe developed at their own institutions,non-blinded arms,and question of external validity.

Endoscopic innovations to increase the adenoma detection rate during colonoscopy

Up to a quarter of polyps and adenomas are missed during colonoscopy due to poor visualization behind folds and the inner curves of flexures, and the presence of flat lesions that are difficult to detect. These numbers may however be conservative because they mainly come from back-to-back studies performed with standard colonoscopes, which are unable to visualize the entire mucosal surface. In the past several years, new endoscopic techniques have been introduced to improve the detection of polyps and adenomas. The introduction of high definition colonoscopes and visual image enhancement technologies have been suggested to lead to better recognition of flat and small lesions, but the absolute increase in diagnostic yield seems limited. Cap assisted colonoscopy and water-exchange colonoscopy are methods to facilitate cecal intubation and increase patients comfort, but show only a marginal or no benefit on polyp and adenoma detection. Retroflexion is routinely used in the rectum for the inspection of the dentate line, but withdrawal in retroflexion in the colon is in general not recommended due to the risk of perforation. In contrast, colonoscopy with the Third-Eye Retroscope® may result in considerable lower miss rates compared to standard colonoscopy, but this technique is not practical in case of polypectomy and is more time consuming. The recently introduced Full Spectrum Endoscopy™ colonoscopes maintains the technical capabilities of standard colonoscopes and provides a much wider view of 330 degrees compared to the 170 degrees with standard colonoscopes. Remarkable lower adenoma miss rates with this new technique were recently demonstrated in the first randomized study. Nonetheless, more studies are required to determine the exact additional diagnostic yield in clinical practice. Optimizing the efficacy of colorectal cancer screening and surveillance requires high definition colonoscopes with improved virtual chromoendoscopy technology that visualize the whole colon mucosa while maintaining optimal washing, suction and therapeutic capabilities, and keeping the procedural time as low and patient discomfort as optimal as possible.

Diagnostic yield of third eye retroscope on adenoma detection during colonoscopy:A systematic review and meta-analysis

AIM： To determine the diagnostic yield of the “third eye retroscope”, on adenoma detection rate during screening colonoscopy.METHODS： The “third eye retroscope” when used with standard colonoscopy provides an additional retro-grade view to visualize lesions on the proximal aspects of folds and fexures. We searched MEDLINE （PubMed and Ovid）, SCOPUS （including MEDLINE and EMBASE databases）, Cochrane Database of Systemic Reviews, Google Scholar, and CINAHL Plus databases to identify studies that evaluated diagnostic yield of “third eye retroscope” during screening colonoscopy. DerSimonian Laird random effects model was used to generate the overall effect for each outcome. We evaluated statistical heterogeneity among the studies by using the Cochran Q statistic and quantifed by I2 statistics.RESULTS： Four distinct studies with a total of 920 pa-tients, mean age 59.83 （95%CI： 56.77-62.83） years, were included in the review. The additional adenoma detection rate （AADR） defined as the number of ad-ditional adenomas identified due to “third eye retro-scope” device in comparison to standard colonoscopy alone was 19.9% （95%CI： 7.3-43.9）. AADR for right and left colon were 13.9% （95%CI： 9.4-20） and 10.7 （95%CI： 1.9-42）, respectively. AADR for polyps ≥ 6 mm and ≥ 10 mm were 24.6% （95%CI： 16.6-34.9） and 24.2% （95%CI： 12.9-40.8）, respectively. The ad-ditional polyp detection rate defined as the number of additional polyps identifed due to “third eye retro-scope” device in comparison to standard colonoscopyalone was 19.8% （95%CI： 7.9-41.8）. There were no complications reported with use of “third eye retro-scope” device.CONCLUSION： The “third eye retroscope” device when used with standard colonoscopy is safe and de-tects 19.9% additional adenomas, compared to stan-dard colonoscopy alone.

基于改进YOLOv5s的肠镜息肉多分类实时检测方法

为了在肠镜检查过程中对结直肠息肉进行快速鉴别检测,提出一种基于改进YOLOv5s的肠镜息肉多分类实时检测模型.该模型采用ConvNeXt作为主干网络,融入SimAM注意力机制提升检测性能,同时在颈部网络中使用基于GSConv的slim-neck模块减少网络参数.为了对模型进行训练和测试,构建了包含1676张息肉图像并由专业医生标注的结直肠息肉数据集.提出的模型在测试集上的平均精度均值(mAP@0.5)为83.0%,相较于改进前提升8.4%,检测速度达到120帧/s.此外,模型在边缘侧部署检测速度超过25帧/s.结果表明,改进的YOLOv5s满足临床结肠镜检查对实时性与准确性的要求.

人工智能辅助结肠镜提高结直肠息肉和腺瘤检出率的研究

目的探讨人工智能辅助结肠镜对结直肠息肉和腺瘤检出率的影响。方法318例患者接受结肠镜检查,第一观察者使用普通结肠镜独立操作(对照组),第二观察者使用人工智能辅助结肠镜系统监测息肉辅助诊断(研究组),并在系统检测到漏诊息肉时提示第一观察者重新评估。比较两组不同部位(近端结肠、远端结肠)、不同大小的腺瘤检出率和息肉检出率的差异。结果研究组息肉检出率和息肉长径≤5 mm的息肉检出率均高于对照组,长径6~9 mm的息肉检出率低于对照组,差异均有统计学意义(χ^(2)分别=20.72、7.87、5.09,P均<0.05)。两组在不同部位息肉检出率和长径≥10 mm的息肉检出率比较,差异均无统计学意义(χ^(2)分别=0.10、2.15,P均>0.05)。研究组的腺瘤检出率高于对照组,差异有统计学意义(χ^(2)=4.12,P<0.05)。两组在不同部位和大小的腺瘤检出率比较,差异均无统计学意义(χ^(2)分别=1.29、0.77,P均>0.05)。结论人工智能辅助结肠镜可以提高息肉与腺瘤的检出率,在提高微小及小息肉检出率方面更有优势。

基于多任务联合注意力的结肠息肉分割网络

结肠息肉具有边界不清晰且大小、颜色、形状各异的特点,使得采用深度学习方法提高其分割性能仍是一项极具挑战性的工作。为提高息肉分割的准确率,提出一种基于多任务联合注意力的结肠息肉分割网络CPMJA-Net。为改善Transformer缺乏机制来增强局部区域信息交换的问题,设计级联融合模块以增强网络的局部特征表示,有助于息肉边缘的识别和恢复。受多头Self-Attention机制的启发,构建多任务注意力模块,采用渐进式融合的方式将不同模块得到的特征图逐步进行融合,以凸显关键信息并抑制干扰信息。为更好聚合图像的高级和低级特征,设计联合注意力模块,利用高级特征的轮廓信息在低级特征中筛选出有利于边缘分割的细节特征,并将其与息肉轮廓聚合起来,得到更加精确的边缘分割结果。实验结果表明,CPMJA-Net在4个公开数据集上的性能表现均为最优,与次优的算法相比,CPMJA-Net的mDice系数分别在Kvasir、CVC-CilinicDB、CVC-ColonDB和ETIS数据集上提升0.7、0.8、0.4、0.4个百分点,平均交并比(mIoU)也分别提升1.6、1.2、0.6、0.5个百分点,其能改善过分割问题,弥补注意力机制的不足,提升解码器的细节恢复能力。

内镜前置活检钳对右半结肠息肉检出率的影响

目的探讨内镜前置活检钳方法对右半结肠息肉检出率的影响。方法收集2022年3月-2022年12月该院诊治的148例经普通电子结肠镜检出右半结肠息肉,于1个月内采用内镜前端前置活检钳方法复检,并行内镜下治疗患者的临床资料,比较两组患者息肉检出数、息肉大小、形态和病理学诊断差异。结果普通肠镜检查组在右半结肠共检出168枚息肉,采用内镜前置活检钳方法复检,普通肠镜检查组漏诊息肉41枚,漏诊率为19.62%。两组患者<5 mm息肉检出率比较,差异有统计学意义(P<0.05)。两组患者息肉形态均以广基隆起型为主,病理性质以管状腺瘤为主,差异均无统计学意义(P>0.05);两组均未发生出血和穿孔等并发症。结论内镜前置活检钳方法能明显提高右半结肠息肉检出率,特别是可以在术中探寻到曾经“消失”的术前确定的肠息肉和直径更小的肠息肉,值得临床进一步推广。

人工智能消化内镜系统辅助结肠息肉诊断的临床应用及影响因素分析

目的:探讨人工智能消化内镜系统辅助诊断对结肠息肉检出情况的影响。方法:回顾性分析2022年10月—2023年10月在安徽医科大学第一附属医院进行内镜检查的150例息肉初筛高危患者的临床资料及检测结果。根据患者意愿,81例接受“影诺鹰眼”人工智能消化内镜系统辅助无痛结肠镜检查,69例接受普通无痛结肠镜检查。比较两种检查方法对结肠息肉的检出率,分析影响检出率的相关因素。结果:结肠息肉总检出率54.00%(81/150),接受无痛结肠镜检查患者的检出率为44.93%(31/69),低于人工智能消化内镜系统辅助无痛结肠镜检查的61.73%(50/81)。检出组患者年龄、男性占比、BMI、有慢性腹泻或便秘症状者占比、有肠道息肉史者占比、肠道准备评分、人工智能消化内镜系统使用率均高于未检出组。Logistic回归分析显示,受检者的年龄及是否使用人工智能消化内镜系统是结肠息肉检出率的独立影响因素,年龄、肠道准备评分和退镜时间是影响人工智能消化内镜系统检出率的独立影响因素。结论:高龄、肥胖、肠道息肉史、慢性腹泻或便秘人群是结肠息肉高发人群,应加强结肠息肉检查;使用“影诺鹰眼”人工智能消化内镜系统辅助检查、提高肠道准备评分、延长退镜时间有助于提高结肠息肉的检出率。