胃と腸48巻4号

2013年04月発行

今月の主題 カプセル内視鏡の現状と展望

主題関連

カプセル内視鏡におけるFICEの有用性

著者： 岡志郎¹ 田中信治¹ 中野誠² 青山大輝² 亘育江² 今川宏樹² 吉田成人¹ 茶山一彰²

所属機関： ¹広島大学病院内視鏡診療科 ²広島大学病院消化器・代謝内科

ページ範囲：P.485 - P.492

文献概要

要旨　分光画像処理機能（FICE）は，通常の内視鏡像から被写体の分光情報を推定し，臓器粘膜病変部の微細な色調変化を強調する内視鏡システムである．ギブン・イメージング社製の小腸用カプセル内視鏡（CE）システムRAPID^® 6.5以降には，画像強調モードとしてFICEが搭載され，小腸内の観察条件に応じてFICE 1～3の3つの設定がプリセットされている．FICEを用いたカプセル内視鏡読影（FICE-CE）のうち，FICE 1とFICE 2は通常観察に比較してangioectasia，びらん・潰瘍，腫瘍の視認性を向上させ，特に微小なangioectasiaの拾い上げ診断能を向上させた．また，CE読影未経験者においても，FICE 1による読影は通常読影と比較してangioectasiaの指摘数を有意に向上させることが明らかとなった．今後，FICE-CEを臨床的にどのように活用するかが重要であり，FICE-CEを用いた診断ストラテジーの確立や自動解析などの臨床応用が期待される．

参考文献

1）Iddan G, Meron G, Glukhovsky A, et al. Wireless capsule endoscopy. Nature 405 : 417, 2000

2）岡志郎，田中信治，宍戸孝好，他．出血性小腸疾患に対する診断・治療の進め方．胃と腸 45 : 312-320, 2010

3）Herrerias JM, Leighton JA, Costamagna G, et al. Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy. Gastrointest Endosc 67 : 902-909, 2008

4）Caunedo-Alvarez A, Romero-Vazquez J, Herrerias-Gutierrez JM. Patency and Agile capsules. World J Gastroenterol 14 : 5269-5273, 2008

5）Mouri R, Yoshida S, Tanaka S, et al. Evaluation and validation of computed virtual chromoendoscopy in early gastric cancer. Gastrointest Endosc 69 : 1052-1058, 2009

6）Togashi K, Osawa H, Koinuma K, et al. A comparison of conventional endoscopy, chromoendoscopy, and the optimal-band imaging system for the differentiation of neoplastic and non-neoplastic colonic polyps. Gastrointest Endosc 69 : 734-741, 2009

7）Imagawa H, Oka S, Tanaka S, et al. Improved visibility of lesions of the small intestine via capsule endoscopy with computed virtual chromoendoscopy. Gastrointest Endosc 73 : 299-306, 2011

8）Imagawa H, Oka S, Tanaka S, et al. Improved detectability of small-bowel lesions via capsule endoscopy with computed virtual chromoendoscopy : A pilot study. Scand J Gastroenterol 46 : 1133-1137, 2011

9）Gupta T, Ibrahim M, Deviere J, et al. Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding. World J Gastroenterol 17 : 4590-4595, 2011

10）Duque G, Almeida N, Figueiredo P, et al. Virtual chromoendoscopy can be a useful software tool in capsule endoscopy. Rev Esp Enferm Dig 104 : 231-246, 2012

11）Nakamura M, Ohmiya N, Miyahara R, et al. Usefulness of flexible spectral imaging color enhancement（FICE）for the detection of angiodysplasia in the preview of capsule endoscopy. Hepatogastroenterology 59 : 1474-1477, 2012

12）Matsumura T, Arai M, Sato T, et al. Efficacy of computed image modification of capsule endoscopy in patients with obscure gastrointestinal bleeding. World J Gastrointest Endosc 16 : 421-428, 2012

13）Kobayashi Y, Watabe H, Yamada A, et al. Efficacy of flexible spectral imaging color enhancement on the detection of small intestinal diseases by capsule endoscopy. J Dig Dis 13 : 614-620, 2012

14）Pohl J, Aschmoneit I, Schuhmann S, et al. Computed image modification for enhancement of small-bowel surface structures at video capsule endoscopy. Endoscopy 42 : 490-492, 2010

15）Yano T, Yamamoto H, Sunada K, et al. Endoscopic classification of vascular lesions of the small intestine（with video）. Gastrointest Endosc 67 : 169-172, 2008

16）Raju GS, Gerson L, Das A, et al. American Gastroenterological Association（AGA）Institute medical position statement on obscure gastrointestinal bleeding. Gastroenterology 133 : 1694-1696, 2007

17）Raju GS, Gerson L, Das A, et al. American Gastroenterological Association（AGA）Institute technical review on obscure gastrointestinal bleeding. Gastroenterology 133 : 1697-1717, 2007

18）Shishido T, Oka S, Tanaka S, et al. Diagnostic yield of capsule endoscopy vs. double-balloon endoscopy for patients who have undergone total enteroscopy with obscure gastrointestinal bleeding. Hepatogastroenterology 59 : 955-959, 2012

19）Kameda N, Higuchi K, Shiba M, et al. A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. J Gastroenterol 43 : 434-440, 2008

20）Shiotani A, Honda K, Kawakami M, et al. Evaluation of RAPID® 5 Access software for examination of capsule endoscopies and reading of the capsule by an endoscopy nurse. J Gastroenterol 46 : 138-142, 2011

21）岡志郎，田中信治，今川宏樹，他．Midgut診療の新展開─モダリティの進歩 : カプセル内視鏡の進歩─FICEシステムの導入．Mod Physician 32 : 815-820, 2012