INTESTINE Vol.18 No.2(1-4)


特集名 炎症性腸疾患の画像診断modality
題名 大腸内視鏡 (4) 超拡大内視鏡
発刊年月 2014年 03月
著者 小林 拓 北里大学北里研究所病院炎症性腸疾患先進治療センター/慶應義塾大学医学部消化器内科
著者 長沼 誠 慶應義塾大学医学部大学病院内視鏡センター
著者 緒方 晴彦 慶應義塾大学医学部大学病院内視鏡センター
著者 日比 紀文 北里大学北里研究所病院炎症性腸疾患先進治療センター
著者 金井 隆典 慶應義塾大学医学部消化器内科
【 要旨 】 近年,共焦点レーザー内視鏡並びにエンドサイトスコープといった,細胞レベルの観察を可能にした“超拡大内視鏡”が開発された.これらの内視鏡は炎症性腸疾患診療においても応用され,炎症の程度をミクロレベルで評価することや,潰瘍性大腸炎関連大腸腫瘍性病変の診断・サーベイランスコロノスコピーにて臨床応用が試みられている.本稿では炎症性腸疾患分野における超拡大内視鏡の現状と展望について概説する.
Theme Imaging modalities for IBD
Title Ultramagnifying endoscopy
Author Taku Kobayashi Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital / Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine
Author Makoto Naganuma Center for Diagnostic and Therapeutic Endoscopy, Keio University Hospital
Author Haruhiko Ogata Center for Diagnostic and Therapeutic Endoscopy, Keio University Hospital
Author Toshifumi Hibi Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital
Author Takanori Kanai Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine
[ Summary ] Endoscopy is an essential tool in clinical practice for patients with inflammatory bowel diseases. Endocytoscope (ECS) and confocal laser endomicroscope (CLE) have been developed recently in order to obtain "supermagnifying" views at histological levels. Both ECS and CLE have been verified to characterize the activity of ulcerative colitis correlating with conventional histopathology using biopsy specimens. CLE has been studied for cancer and dysplasia screening when conducting surveillance colonoscopy. Some reports have suggested this modality provides better identification of neoplastic lesions in long-standing ulcerative colitis (UC). It may also be useful to distinguish adenoma-like mass from dysplasia-associated lesion or mass. However, there are issues which must be resolved in order for this method to widely used. These include time consuming procedures and the training of endoscopists. High quality clinical studies are necessary to further confirm the clinical feasibility of these devices.
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