ABSTRACT
Objective To study the consistency and complementarity of endoscopic ultrasonography (EUS),white light endoscopy (WLE) and magnifying endoscopy (ME) in diagnosis of ulcerative colitis (UC).Methods We collected 125 cases of UC patients diagnosed by WLE and EUS (including 51 cases of WLE + ME + EUS).According to UC mucosal morphology under WLE and crypt openings under ME,we divided all the cases into several groups and analyzed intestinal wall thickness (TWT) under EUS in each group.Results According to the results of UC inflammation degree under WLE,all patients were divided into four groups: 16 severe cases,46 moderate cases,44 mild,and 19 remission stage.TWT results were (5.903 ± 1.551 ) mm,(4.673 ± 1.235 ) mm,(3.756 ± 1.322 )mm and ( 3.464 ± 0.970) mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ),except for that between mild and remission groups.According to the results of UC inflammation degree under ME,all patients were divided into six groups: 9 cases of villous-like structure,9 cases of typical coral reef-like structure,8 severe coral reef-like structure,13 regular crypt opening,6 epithelial minimal defect and 6 small yellow spot (SYS).TWT results were (5.701 ±0.941 )mm,(5.518 ±0.581 )mm,(5.181 ±0.751 )mm,(3.763 ±0.659) mm,(3.587 ±0.461 )mm and (2.505 ± 0.330 )mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ) except for those between epithelial minimal defect and regular crypt opening,typical coral reeflike structure,villous-like and severe coral reef-like structure.EUS results showed SYS (6/6) and regular crypt opening ( 10/13 ) were mostly located in mucosa,while lesions of severe coral reef-like structure (8/8) invaded the muscularis propria.Conclusion EUS shows high consistency with WLE and ME in diagnosis of UC inflammation degree and invasive depth.It could assist and even substitute ME for evaluation.
ABSTRACT
Objective To observe the meshed capillary pattern(CP)on the surface of colorectal lesions by narrow-band imaging system with magnifying endoscopy(NBI-ME),and to distinguish neoplasm from non-neoplasm by the change of capillary patterns.Methods A total of 144 colorectal lesions in 102 patients detected by conventional colonoscopy were evaluated by NBI-ME to observe the CP on surface,and by staining magnifying colonoscopy to observe the pit pattern.Results All lesions were resected endoscopically (129/144)or by surgery(15/144),and the pathological evaluation diagnosed 30 cases of non-neoplasm (including 20 cases of hyperproliferative polyps and 10 of inflammatory polyps)and 1 14 cases of neoplasm (including 95 cases of adenoma and 19 cases of adenocarcinoma).The diagnostic accuracy rate,sensitivity and specificity of conventional colonoscopy were 75.7%,85.1%and 40.O%,respectively,which were significantly lower than those of NBI-ME and staining magnifying colonoscopy(P＜0.005),while there was no significant difference between NBI-ME and staining magnifying colonoscopy.The CP of type Ⅰ,Ⅱ,Ⅳ and Ⅵa were totally correspondent with pit pattern of type Ⅰ,Ⅱ,Ⅳ and ⅤI. Conclusion NBI-ME findings of colorectal lesions correlated with those of staining magnifying colonoscopy.These two techniques are both helpful in differentiating colorectal neoplasms from non-neoplasms.