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Study on the vascular structure of esophagial varices using infrared fluorescent endoscopy

红外荧光内镜对食管静脉曲张血管结构的研究

基本信息

批准号：
12670492
负责人：
SHIBATA Hiroshi
金额：
$ 1.22万
依托单位：
The University of Tokushima
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12670492/
关键词：
Infrared fluorescent Indocyanine green esophageal varices Diagnosis 食道静脈癌

项目摘要

Several studies reported that infrared endscopy (IRE) is useful for examining esophageal varices. Although infrared fluorescence has been used in the field of ophthalmology and dermatology, it has not yet been used in endoscopy for the digestive tracts. Using infrared fluorescent endoscopy (IRFE) developed by Ito et al., the present study evaluated the detectability of esophageal varices. The subjects were 12 patients with esophageal varices. The postoperative course of these patients were followed after the treatment by endoscopic variceal ligation (EVL) or endoscopic injection sclerotherapy (EIS). ICG was administered intravenously at k different doses (2 mg/kg, 0.2 mg/kg, or 0.01 mg/kg), and infrared fluorescent images were acquired. The entire esophageal mucosae were visualized by strong white infrared fluorescence in 2 patients treated with 2 mg/kg of ICG and in 2 patients treated with 0.2 mg/kg of ICG. Therefore, the discrimination of esophageal varices from the normal mucosae was difficult in these patients. Infrared fluorescence corresponding to the esophageal varices observed by conventional endoscopy was clearly observed in 7 patients treated with 0.01 mg/kg of ICG. IRFE facilitated the visualization of microvessels after endoscopic treatment of esopliageal varices. In addition, tissues other than blood vessels did not show infrared fluorescence. Compared to conventional IRE, IRFE facilitated the observation of esophageal varices after intravenously injecting a markedly small amount of ICG. Therefore, IRFE may be useful for preventing ICG-induced complications. In the future, due to its higher sensitivity and specificity, IRFE may be used in the diagnosis of vascular lesious in the digestive tract as a novel diagnostic endoscopy.

几项研究报告，红外内镜（IRE）是有用的检查食管静脉曲张。虽然红外荧光已用于眼科和皮肤科领域，但尚未用于消化道内窥镜检查。使用Ito等人开发的红外荧光内窥镜（IRFE），本研究评价了食管静脉曲张的可检测性。研究对象为12例食管静脉曲张患者。术后随访内镜下食管静脉曲张结扎术（EVL）或内镜下注射硬化剂治疗（EIS）的疗效。以k个不同剂量（2 mg/kg、0.2mg/kg或0.01mg/kg）静脉内施用ICG，并获取红外荧光图像。在2 mg/kg ICG治疗的2例患者和0.2 mg/kg ICG治疗的2例患者中，整个食管粘膜通过强白色红外荧光可视化。因此，在这些患者中很难区分食管静脉曲张和正常粘膜。在7例接受0.01 mg/kg ICG治疗的患者中，清晰观察到与常规内镜观察到的食管静脉曲张相对应的红外荧光。IRFE有助于食管静脉曲张内镜治疗后微血管的可视化。此外，血管以外的组织未显示红外荧光。与传统的IRE相比，IRFE在静脉注射明显少量的ICG后便于观察食管静脉曲张。因此，IRFE可能有助于预防ICG引起的并发症。IRFE具有较高的敏感性和特异性，有望成为一种新型的诊断内镜，用于消化道血管性病变的诊断。