Usefulness of Magnifying Chromoscopy in Ulcerative Colitis / 대한소화기내시경학회지

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.

Clinical application of magnifying chromoscopy in detection and diagnosis of colorectal elevated lesion / 中华消化杂志

Objective To evaluate the clinical value of magnifying chromoscopy in combination with Kudo criteria in detection and diagnosis of colorectal lesions. Methods After conventional electronic colonoscopic diagnosis of 125 colorectal lesions, staining and magnifying observation by chromoscopy were made with Kudo criteria, and biopsy specimen and resected samples were sent for pathologic examinations. Results The accuracy of ordinary colonoscopy and magnifying colonoscopy compared with histological diagnosis of inflammatory polyps, tubular adenomas, villous adenomas and colorectal cancer was 95.62%, 80%, 90% and 100% respectively and 100%, 93.75%, 92.86% and 100% respectively. The overall accuracy of two procedures was 85.6% and 95.2% respectively. Conclusions Magnifying chromoscopy is valuable in detection of tiny and slightly elevated colorectal lesion, and has high efficacy in judging the nature of lesions with Kudo criteria.