摘要目的 探讨窄带成像(NBI)放大内镜和染色放大内镜对结直肠肿瘤性和非肿瘤性病变的鉴别诊断价值.方法 75例患者92处病变分别在常规内镜模式、NBI放大模式及染色放大模式下进行观察,对发现的病变进行腺管开口分型及血管形态分型,将内镜诊断结果与病理诊断结果进行对比分析.结果 常规内镜检出87处(94.6％)病灶,NBI放大内镜检出90处(97.8％),染色放大内镜全部检出(100.0％).在病变轮廓、微血管形态的图像显示上NBI放大内镜明显优于染色放大内镜(P=0.000),在腺管开口形态的图像显示上NBI放大内镜与染色放大内镜比较差异无统计学意义(P=0.394).NBI放大内镜诊断结直肠肿瘤性病变的符合率、敏感度、特异度分别为91.3％(84/92)、83.9％ (26/31)、95.1％ (58/61),染色放大内镜则对应分别为89.1％(82/92)、80.6％(25/31)、93.4％(57/61),两者比较差异均无统计学意义(P＞0.05).结论 NBI放大内镜和染色放大内镜对结直肠肿瘤性、非肿瘤性病变的鉴别效果相似,但NBI放大内镜能更为清晰地显示病变轮廓、微血管形态,且操作转换简单快捷,更易于临床推广应用.

abstractsObjective To compare differential diagnostic value of narrow-band imaging (NBI) magnifying endoscopy and magnifying chromoendoscopy.Methods A total of 92 lesions from 75 patients were examined with conventional colonoscopy,NBI magnifying endoscopy and magnifying chromoendoscopy to evaluate pit patterns and vascular morphology patterns.Endoscopic findings were compared with the pathological results.Results The detection rate of conventional endoscopy,NBI magnifying endoscopy and magnifying chromoendoscopy were 94.6％ (87/92),97.8％ (90/92) and 100.0％ (92/92),respectively.NBI magnifying endoscopy was superior to the magnifying chromoendoscopy (P =0.000) in the the lesion contour and microvessels pattern detection,but there was no difference in the pit patterns detected with the two techniques (P =0.394).Consistency,sensitivity,and specificity of NBI magnifying endoscopy in diagnosis of colorectal neoplastic lesions were 91.3％ (84/92),83.9％ (26/31),95.1％ (58/61),respectively,while these variables of magnifying chromoendoscopy were 89.1％ (82/92),80.6％ (25/31),93.4％(57/61),which were not statistically significant (P ＞ 0.05).Conclusion Differential diagnostic value of NBI magnifying endoscopy and magnifying chromoendoscopy for colorectal neoplastic and non-neoplastic lesions was similar,but NBI magnifying endoscopy displays the lesion contours and microvessels clearlier,and is easy to manipulate.