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.

几项研究报告称，红外内窥镜检查（IRE）对于检查食管静脉曲张非常有用。尽管红外荧光已应用于眼科和皮肤科领域，但尚未用于消化道内窥镜检查。本研究使用 Ito 等人开发的红外荧光内窥镜 (IRFE) 评估了食管静脉曲张的可检测性。研究对象为 12 名食管静脉曲张患者。通过内镜下静脉曲张结扎术（EVL）或内镜下注射硬化剂治疗（EIS）治疗后，对这些患者的术后病程进行随访。以 k 个不同剂量（2 mg/kg、0.2 mg/kg 或 0.01 mg/kg）静脉注射 ICG，并获取红外荧光图像。 2 名接受 2 mg/kg ICG 治疗的患者和 2 名接受 0.2 mg/kg ICG 治疗的患者的整个食管粘膜通过强白色红外荧光可见。因此，在这些患者中区分食管静脉曲张与正常粘膜很困难。在接受 0.01 mg/kg ICG 治疗的 7 例患者中，清晰地观察到与常规内窥镜检查所观察到的食管静脉曲张相对应的红外荧光。 IRFE 有助于内窥镜治疗食管静脉曲张后微血管的可视化。此外，血管以外的组织没有显示出红外荧光。与传统IRE相比，IRFE有利于静脉注射极少量ICG后观察食管静脉曲张。因此，IRFE 可能有助于预防 ICG 引起的并发症。未来，IRFE由于其较高的敏感性和特异性，可能作为一种新型的诊断内镜用于消化道血管病变的诊断。