Diagnosis of specialized intestinal metaplasia by optical coherence tomography
Diagnosis of specialized intestinal metaplasia by optical coherence tomography
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DOI：
10.1053/gast.2001.20911
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发表时间：
2001-01-01
期刊：
影响因子：
29.4
通讯作者：
Nishioka, NS
中科院分区：
文献类型：
--
作者：
Poneros, JM;Brand, S;Nishioka, NS
背景与目的：光学相干层析成像(OCT)是一种在活体内产生高分辨率断层图像的成像技术。目的：探讨OCT在诊断特发性肠化生(SIM)中的敏感性和特异性。方法：采用OCT对121例患者的胃和食道进行成像。总共获得了288张与活检相关的OCT图像。通过对75张SIM卡图像的分析，制定了SIM卡的OCT标准。通过将SIM图像标准应用于胃、鳞状上皮、SIM和心脏上皮的图像，对SIM图像标准进行了回顾性测试。然后对这些标准进行前瞻性测试，以确定OCT诊断SIM的敏感性和特异性。结果：SIM的OCT图像特征为：(1)缺乏正常鳞状上皮的层状结构和胃粘膜垂直的“凹陷”形态；(2)结构紊乱，组织对比度不均匀，粘膜表面不规则；(3)黏膜下腺的存在，回顾应用时，这些指标对SIM的敏感性为100%，特异性为93%；前瞻性检测时，敏感性为97%，特异性为92%。结论：OCT对SIM具有高度的敏感性和特异性，有助于对该癌前病变的诊断和监测。
Background & Aims: Optical coherence tomography (OCT) is an imaging technique that produces high-resolution cross-sectional images in vivo. The aim of this study was to establish the sensitivity and specificity of OCT for diagnosing specialized intestinal metaplasia (SIM), Methods: OCT was used to image the stomach and esophagus of 121 patients. A total of 288 biopsy-correlated OCT images were acquired. OCT criteria for SIM were formulated by analyzing 75 images of SIM. The SIM image criteria were retrospectively tested by applying them to images of gastric, squamous, SIM, and cardiac epithelium. The criteria were then tested prospectively to determine the sensitivity and specificity of OCT for diagnosing SIM. Results: OCT images of SIM are characterized by (1) absence of the layered structure of normal squamous epithelium and the vertical "pit and crypt" morphology of gastric mucosa, (2) disorganized architecture with inhomogeneous tissue contrast and an irregular mucosal surface, and (3) presence of submucosal glands, These criteria were 100% sensitive and 93% specific for SIM when applied retrospectively and 97% sensitive and 92% specific when tested prospectively, Conclusions: OCT is highly sensitive and specific for SIM and may aid in the diagnosis and surveillance of this preneoplastic lesion.