窄带成像放大内镜在Barrett食管中的诊断价值

目的:探讨窄带成像放大内镜(NBI-ME)对Barrett食管(BE)的诊断价值。方法:对968例以反酸、嗳气、烧心为主诉的患者行普通内镜及NBI内镜检查,评价两种内镜图像清晰度,统计BE病灶数目。在NBI模式下对BE病灶进行放大内镜(ME)检查,对BE黏膜腺管开口形态进行Goda分型,异常部位行定向取检,统计特殊肠上皮化生(SIM)检出率。结果:NBI诊断BE 86例,其中15例普通内镜阴性,NBI发现病灶数目多于普通内镜(P<0.01)。NBI对鳞柱状上皮交界处轮廓、BE病灶图像的清晰度明显优于普通内镜(P<0.01)。NBI-ME下Ⅳ型及Ⅴ型腺管开口形态检出SIM准确性、敏感性、特异性分别为94%、91%、95%。结论:NBI-ME有助于BE的早期诊断,并能提高SIM检出率。

Diagnostic Value of Narrow-band Imaging System with Magnifying Endoscopy in Barrett's Esophagus

Objective To explore the diagnostic value of narrow-band imaging system with magnifying endoscopy（NBI-ME） in Barrett＇s esophagus（BE）.Methods A total of 968 patients with regurgitation,belching and heartburn were detected with common endoscope and NBI-ME,the image quality of the two kinds of endoscope were compared and the focus number in BE were counted.The focus were observed with NBI-ME and the abnormal region were given biopsy,the BE mucosal pit pattern was based on Goda type and the detective rate of specialized intestinal metaplasia（SIM） were calculated.Results Eighty-six patients with BE were diagnosed with NBI,in which there were 15 cases showed negative under common endoscope.The focus number diagnosed with NBI-ME was more than that dignosed with common endoscope（P0.01）.The profile of squamous columnar epithelium and clarity of BE focus were obviously better visualized in NBI than in common endoscope（P0.01）.The accuracy,sensitivity,specificity of SIM detection in type Ⅳ and Ⅴ pit pattern by NBI-ME were 94%,91%,95%,respectively.Conclusion NBI-ME could improve the early diagnostic rate of BE and the detection rate of SIM.