放大内镜对大肠病变微血管形态观察PPT课件.ppt

Horimatsu T通过NBI结合放大内镜研究轻度不典型增生与重度不典型增生大肠病变的MC (meshed-capillary )微血管形态相关性.结果发现,NBI结合放大内镜发现98% (44 of 45) 的轻度不典型增生病变存在MC，而92% (23 of 25)的重度不典型增生缺乏MC,因此认为有无MC为判别是否有肿瘤血管新生标志. Horimatsu T, et al. 1:Hepatogastroenterology. 2009 ;56(90):372-7. 电子分光显像技术(FICE) (FUJI INTELLIGENT CHROMO ENDOSCOPE ) FICE的原理 將選定的分光圖像還原為FICE圖像 分解為單一波長的分光圖像 分光光譜 分光圖像還原為FICE圖像 普通的彩圖 ＦＩＣＥ圖像 將普通的彩圖分解為單一波長的分光圖像 ◆ 当红绿蓝三色光的波长分别为605nm、540nm、415nm时，所折射的颜色是原本实际的彩色图像。 ◆ 血液和血红蛋白是传播和折射光线最好的媒介 ◆ 不同的波長的光可以穿透到粘膜不同的深度，从而显示不同深浅度的血管。 ◆ 通过改变波长可以有的放矢的观察不同个体和不同深浅部位的血管走形，从而判断病情。 Ｒ550 Ｇ500 Ｂ4０0 Ｒ540 Ｇ415 Ｂ415 原图象 FICE图象 Ｒ550 Ｇ500 Ｂ4０0 FIGURE 3. A: PIT PATTERN OF TYPE II, SOME LIGHT BROWN BLOOD CAPILLARY ARE SHOWN (R: 540 NM, G: 440 NM, B: 415 NM). 3B: pit pattern of type IIIL, branch brown blood capillary are shown (R: 560 nm, G: 460 nm, B: 415 3D: pit pattern of type V, heavy brown blood capillary net are shown, it is in disorder, some vessels were destroyed 3C: pit pattern of type IV, much heavy brown branch blood capillary net are shown, the vessel is large in diameter 4A: pit pattern of type IIIL shown by FICE, branch light brown blood capillary is shown; it is staged as a tubular adenoma by pathology 4B: pit pattern is clear shown by magnifying chromoendoscopy, but blood capillaries are unclear. 5A: pit patterns are types IV and V shown by magnifying FICE, tumor vessels are in the shape of branch and curvature , it is as villous adenoma by pathology 5B: pit pattern is type IV shown by magnifying chromoendoscopy, tumor vessels are indistinct, the form of the vessel is unclear and it is identified as a villous adenoma by pathology. 6A: pit pattern is type V shown by magnifying FICE, the terminal line between the tumor and surrounding tissue is clear, tumor vessels are large and torturous, blood capillaries are dense 6B: terminal line of the tumor is clear, but tumor vessels are unclear. 7A: the terminal line of the tumor and the surrounding tissue are obscure on i