| Theme |
NBI in colon and rectum |
| Title |
The surface microvasculature of colorectal lesions observed with NBI zoom system ; including comparison with pit pattern analysis |
| Author |
Yoshiki Wada |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hiroshi Kashida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Ken-ichi Mizuno |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Nobunao Ikehara |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Yui Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Yasutoshi Kobayashi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Fuyuhiko Yamamura |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Jun-ichi Ukegawa |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Keiko Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Kenta Kodama |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Orie Takemura |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Kazuo Ohtsuka |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shigeharu Hamatani |
Department of Pathology, Showa University Northern Yokohama Hospital |
| [ Summary ] |
Narrow Band Imaging emphasizes the surface microvasculature of the GI tract and may help in detecting small neoplasms. However, in this article we studied the possibility of utilizing a NBI system for tissue characterization and differential diagnosis. We examined 159 localized lesions, first with magnified narrow band imaging and then with magnified chromoscopic imaging. We then submitted the lesions for endoscopic or surgical treatment. The normal colonic mucosa presented a normal patterned vasculature. The vessels in hyperplastic polyps were rather thin histologically and also obscure in NBI. We have termed the appearance as a “faint” pattern. Tubular adenomas showed regular vessel network patterns with NBI. In villous and tubulovillous adenomas the vessels were well developed and rather thick. We term the appearance of that tissue as a “dense” pattern. The vascular structures in high grade adenomas and early cancers were different varied with different gross appearances. Protruded high grade adenomas showed either network patterns or dense patterns. In protruded, submucosally invasive cancers the vessels were thick and irregular. In contrast, the depressed type lesions, especially depressed invasive cancers, were characterized by decreased vessels (sparse pattern). The vascular patterns in flat-elevated early cancers were somewhat similar to protruded cancers and depressed cancers. The nodule-mixed subtype showed irregular patterns while the pseudodepressed subtype showed sparse patterns.
It is too early to recommend that NBI be used to replace dye-staining. At present, we consider NBI to be a supplement to chromoendoscopy, not as a substitute for it. |