Is High Resolution Magnifying Colonoscope Combined with Indigo Carmine Dye (ICD) Scattering Useful for the Diagnosis of Colorectal Tumors? Hideki Mitooka 1 , Katsurou Sirakawa 1 , Kazuhiko Irie 1 , Ryoichi Kashiwagi 2 , Kazuo Nishitani 2 1Center for Digestive Diseases, Kobe Kaisei Hospital 2Tabata Gastrointestinal Hospital Keyword: 高画素拡大電子内視鏡 , インジゴカルミン , 拡大観察 , 通常観察 , 深達度診断 pp.1665-1673
Published Date 1999/12/25
DOI https://doi.org/10.11477/mf.1403102898
  • Abstract
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 We carried out this study to validate the usefulness of magnified observation by comparing the accuracy of its diagnosis for colorectal tumors with that of ordinary observation using video. Twenty lesions (10: adenoma & m or sm1 cancer,10: sm cancer deeper than sm2) were recorded using a high resolution magnifying colonoscope 〔Fujinon EC400 (410) CM or 410CW〕 without ICD (ordinary observation) and with ICD (magnified observation) by video (S-VHS). Six colonoscopists 〔3 beginners (Group A) & 3 experienced (Group B) 〕 reviewed an edited video tape composed of short segments of the 20 randomly-arranged lesions without and with ICD in succession. They were instructed to predict each lesion's histology (adenoma or cancer) and depth of invasion (m, sm1 or deeper than sm2) based on the findings by ordinary observation and also by magnified observation (including pit pattern).

 Average detection rate of pit pattern for the lesions was 15% by ordinary observation, and 90% by magnified observation. In magnified observation, average detection rate of group A was 80%, and that of group B was 98% (p< 0.01). There was no significant difference regarding diagnostic accuracy of each lesion's histology between two groups. Diagnostic accuracy rate of the depth of invasion is significantly higher by magnified observation combined with ICD than by ordinary observation without ICD especially in colorectal tumors deeper than sm2.

 Detection of pit pattern depends on the level of endoscopic (magnifying colonoscope) experience. High resolution magnified observation combined with ICD was superior to ordinary observation without ICD in prediction of depth of invasion of colorectal tumors especially of deep invasive cancers.

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