Endoscopic Diagnosis Of Chronic Gastritis By Image Enhancement Observation Method Number:4a02c073...
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![Page 1: Endoscopic Diagnosis Of Chronic Gastritis By Image Enhancement Observation Method Number:4a02c073 Name:Chen,Chia-Sheng Professor:Wang,Ming-Shyan Date:2015/05/21.](https://reader035.fdocuments.us/reader035/viewer/2022062422/56649eef5503460f94bfed8f/html5/thumbnails/1.jpg)
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
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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
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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
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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
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Image Enhanced Endoscopy (tri-modal imaging):WLI,NBI,AFI
(三模態成像 )
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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
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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
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Chromoendoscopic observations on extension and develoment of fundal gastritis and
intestinal metaplasia
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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…
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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
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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
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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
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Diagnostic accuracy of LBC for histological IM
88 recorded images by three endoscopists
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Thanks for listening