Abstract
Barrett’s esophagus (BE) is a condition of the distal esophagus involving columnar-lined epithelium (CLE) with intestinal metaplasia (IM). During conventional endoscopy, IM in CLE is not clearly identifiable. Here we describe a technique of magnifying endoscopy (ME) using narrow-band imaging (NBI) in combination with acetic acid institllation in the diagnosis of BE. Within 10–20 s after acetic acid instillation, the mucosal surfaces whiten and fine mucosal surface patterns become clearer with ME emphasized with NBI.
We classified CLE surface patterns into five types: type I, small round pits of uniform size and shape; type II, slit-like pits; type III, gyrus and villous pattern; type IV, irregular size and arrangement; type V, destructive pattern. A significant correlation between type III pattern and the presence of IM was observed (sensitivity 88.5%, specificity 90.2%, and overall accuracy 90.0%). Most adenocarcinomas expressed type IV or type V patterns. ME in combination with NBI and acetic acid instillation seems to be useful for identifying IM and early adenocarcinomas in CLE.
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Tanaka, K., Toyoda, H., Jaramillo, E. (2008). Magnifying Endoscopy in Combination with Narrow-Band Imaging and Acetic Acid Instillation in the Diagnosis of Barrett’s Esophagus. In: Niwa, H., Tajiri, H., Nakajima, M., Yasuda, K. (eds) New Challenges in Gastrointestinal Endoscopy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-78889-8_14
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DOI: https://doi.org/10.1007/978-4-431-78889-8_14
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-78888-1
Online ISBN: 978-4-431-78889-8
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