New endoscopic imaging techniques in surveillance ofinflammatory bowel disease

• 作者: Tommaso Gabbani Natalia Manetti Andrea Giovanni Bonanomi Antonio Luca Annese Vito Annese
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: ULCERATIVE COLITIS Crohn's disease ENDOSCOPY SURVEILLANCE COLORECTAL cancer
• 年，卷（期）: 2015,（3）
• 页码范围: 230-236
• 页数: 7页
• 分类号: R

摘要

Endoscopy plays a crucial role in the managementof inflammatory bowel disease （IBD）. Advancesimaging techniques allow visualization of mucosaldetails, tissue characteristics and cellular alteration. Inparticular chromoendoscopy, magnification endoscopy,confocal laser endomicroscopy and endocytoscopyseem to have the possibility to radically modify theapproach to surveillance and decision making. Dyebasedchromoendoscopy （DBC） and magnificationchromoendoscopy improve detection of dysplasia,and evaluation of inflammatory activity and extensionof ulcerative colitis and are thus considered thestandard of care. Dye-less chromoendoscopy couldprobably replace conventional DBC for surveillance.Narrow band imaging and i-scan have shown toimprove activity and extent assessment in comparisonto white-light endoscopy. Confocal laser endomicroscopy（CLE） can detect more dysplastic lesions insurveillance colonoscopy and predict neoplastic andinflammatory changes with high accuracy comparedto histology. This technology is best used in conjunctionwith chromoendoscopy, narrow-band imaging, orautofluorescence because of its minute scanning area.This combination is useful for appropriate tissueclassification of mucosal lesions already detectedby standard or optically enhanced endoscopy. Thebest combination for IBD surveillance appear tobe chromoendoscopy for identification of areas ofsuspicion, with further examination with CLE to detectintraepithelial neoplasia. However cost, availability, andexperience are still an issue.