endoscopic diagnosis of chronic gastritis by image enhancement observation method number:4a02c073...
TRANSCRIPT
Endoscopic Diagnosis Of Chronic Gastritis By Image Enhancement Observation Method
Number:4a02c073
Name:Chen,Chia-Sheng
Professor:Wang,Ming-Shyan
Date:2015/05/21
Noriya Uedo, Gastrointestinal cancer (esophagus, stomach, large intestine) and endoscopic diagnosis and treatment
UICC, Osaka Medical Center for Cancer and Cardiovascular Disease
Outline
Basic policy Image enhanced endoscopy for diagnosis of chronic gastritis and
carcinoma Pathogenesis of gastric cancer
H. pylori-associated gastritis Chromoendoscopy Autofluorescence imaging Narrow band imaging
Basic policy
Many endoscopists, particularly in the West, considered the Japanese classification, with its numerous divisions for esophagus, stomach, and colon, to be a "botanical hobby", too complex for practical use. Lambert R, GIE 2003;58 (SUPPL)
I ain't looking to compete with you…classify you… All I really want to do is be friends with you Dylan B, 1964
Image Enhanced Endoscopy
Dye-based IEE 染料基於圖像增強內鏡 (chromoendoscopy 色素 ): Absorptive dye 吸收染料 Lugol’s solution 盧戈氏液 Methylene blue 亞甲藍
Contrast dye 造影劑 Indigo carmine 靛藍胭脂紅
Equipment-based IEE 設備基於圖像增強內鏡 : Optical 光學 Narrow band imaging 窄頻成像
Electronic 電子 Spectral estimation technology 光譜估計技術 : FICE富士智能色彩增強技術
Surface enhancement technology 表面增強技術 Autofluorescence imaging 自體螢光成像
Image Enhanced Endoscopy (tri-modal imaging):WLI,NBI,AFI
(三模態成像 )
Chronic gastritis as a cancer precursor
H. Pylori infection( 感染 )
↓
Acute gastritis( 急性胃炎 )
↓
Chronic gastritis( 慢性胃炎 )
↓
Atrophic gastritis( 萎縮性胃炎 )
↓
Intestinal metaplasia( 腸上皮化生 )
↓
Dysplasia( 發育異常 )
↓
Carcinoma
Relationship of gastroscopic feature to histological findings in gastritis and Helicobacter pylori infection in a general population sample
H. pylori (-) normal mucosa陰性反應正常的黏膜
Chronic atrophic gastritis慢性萎縮性胃炎
Sensitivity (%)Specificity 差異性 (%)Visible vessels 可見血管48 (26-70) 87 (84-90)Absence of rugae 67 (43-85) 85 (82-88)有無皺褶
Chromoendoscopic observations on extension and develoment of fundal gastritis and
intestinal metaplasia
Color difference in autofluorescence image自體螢光的顏色差異
0
0.1
0.2
480 580 680 780
Background mucosaGastric cancer
Fluorophores
• Mucosal thickening 黏膜增厚• Increased blood flow 增加血流
量 (Hb)• Different tissue structure 不
同的組織結構 etc…
Color difference of background mucosa in AFI imageAFI圖像背景粘膜色差
H. pyloriNegative(-)
Atrophic fundic gastritis 萎縮性胃
體胃炎
Diagnostic accuracy of green mucosa in gastric body by AFI for gastritis
由 AFI胃炎的診斷綠色胃體黏膜的準確性
Narrow band imaging,NBI窄頻成像
Xenon
Lamp
NBIfilter
RGB Rotary Filter
ON
OFF
400 500 600 nm
White light image(RGB broad band)
Hb absorption curve
Narrow band image
Diagnostic accuracy of LBC for histological IM
88 recorded images by three endoscopists
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