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Flexible imaging color enhancement improves visibility of transnasal endoscopic images in diagnosing esophageal varices: A multicenter prospective blinded study
Author(s) -
Furuichi Yoshihiro,
Kawai Takashi,
Ichimura Shigeki,
Metoki Ryo,
Miyata Yuki,
Oshima Toshihiro,
Sano Takatomo,
Murashima Eigaku,
Taira Junichi,
Sugimoto Katsutoshi,
Kamamoto Hiroyuki,
Imai Yasuharu,
Moriyasu Fuminori
Publication year - 2012
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1751-2980.2012.00643.x
Subject(s) - medicine , esophagogastroduodenoscopy , esophageal varices , intraclass correlation , endoscopy , sedation , scars , radiology , nuclear medicine , surgery , cirrhosis , portal hypertension , clinical psychology , psychometrics
Objective To clarify the usefulness of transnasal esophagogastroduodenoscope ( N ‐ EGD ) with all flexible imaging color enhancement ( FICE) patterns (0–9) for the diagnosis of esophageal varices ( EV ). Methods A total of 50 patients with EV were examined during the same period by N ‐ EGD without sedation and by peroral endoscopy ( O ‐ EGD ) with sedation. The visibility of treatment scars, microvessels, recurrent EV and red color sign ( RCS ) were measured. Visibility was evaluated by five blinded observers (poor–good: 0–10), and the effect of both endoscopic examinations on the cardiorespiratory function of the patients was measured. Results The image scores for O ‐ EGD and N ‐ EGD with ordinary mode and N ‐ EGD with FICE were 7.3 ± 1.2, 6.1 ± 1.0 and 6.9 ± 1.0 for treatment scars; 7.2 ± 1.4, 6.2 ± 1.2 and 7.3 ± 1.0 for microvessels; 7.2 ± 1.2, 6.1 ± 1.0 and 7.1 ± 1.0 for recurrent EV and 7.2 ± 1.3, 6.1 ± 1.3, and 7.2 ± 1.2 for RCS , respectively (intraclass correlation coefficients > 0.6). When FICE patterns 2, 6 and 9 were used, visibility was much improved. Ten minutes after insertion, the double product values in the N ‐ EGD with the FICE group were significantly better ( P < 0.05). Conclusions N ‐ EGD with FICE is very useful for the diagnosis of EV and can improve the visibility of N ‐ EGD on each lesion to the same level as that of O ‐ EGD . N‐ EGD with FICE does not require sedation and may reduce the risk of hepatic encephalopathy.