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Electronic chromoendoscopy
Release time:
2025-03-12 09:38
In recent years, with the continuous development of endoscopy technology, more and more new technologies have been applied to clinical diagnosis, including:Electronic chromoendoscopy technologyallows doctors to clearly observe the fine structure of the lesion, clarify the location and nature of early lesions, and provides a powerful weapon for early tumor screening.
Taking the "three giants of endoscopy" as an example, the common electronic chromoendoscopy technologies mainly include Olympus'sNBI、Fuji'sFICEandLasereoand Pentax'si-Scanetc. Today, I will firstintroduce Olympus' NBI technology.
Function Introduction
Narrow Band Imaging
NBI
Narrow Band Imaging
Narrow band imaging refers to an image enhancement technology that emphasizes the optical images of blood vessels on the mucosal surface, fine mucosal structures, and areas where capillaries are concentrated by narrowing the spectral range on the light source.
Related Functions
Structure EnhancementThis refers to an image enhancement observation function realized by digital methods, which electronically enhances the fine morphology and contours of the mucosa, increasing the contrast. It is divided into A and B modes, and can be set from 0 to 8 levels (level 0 is off).
A mode: relatively large morphology as the observation object;
B mode: relatively fine morphology as the observation object (recommended for use with high-definition endoscopes).
Color EnhancementCompared with "1", adjusting to "3" weakens the red and blue chroma and increases the green chroma, so that the superficial vessels and surrounding mucosa represented by tea color in the colon can be more clearly displayed.
Working Principle
The structure shown in the dashed box in the figure above includes the NBI filter, AFI filter, spare bulb, etc. When the NBI function is enabled, the corresponding filter will automatically be connected to the optical path.
Traditional electronic endoscopes use xenon lamps as illumination, and their wavelength range covers the visible spectrum. Studies have shown that the depth of penetration of photons into the gastrointestinal mucosa depends on the wavelength of the light source, with shorter wavelengths penetrating less deeply. In addition, hemoglobin is the main substance that absorbs visible light, with a high absorption rate for blue and green light, and basically no absorption for red light.
Based on this principle, NBI technology uses a narrow-band interference blue/green filter to generate blue-green narrow-band light waves with center wavelengths of415nmand540nmand a bandwidth of 30nm as the illumination source.When the center wavelength is415nmthe light irradiating the blood vessels is absorbed by hemoglobin and hardly returns to the mucosal surface. However, the light irradiating the surrounding tissue of the blood vessels hardly diffuses and returns as reflected or scattered light. As a result, when observing blood vessels from the surface of the body tissue, a very densely stained structure is presented. In addition, in order to display deeper blood vessels, it is necessary to use incident light with a wavelength longer than415nmand a greater hemoglobin absorption.540nmIncident light.
When switching to NBI mode, the NBI filter is rotated to the front of the lamp. At this time, the white light emitted from the bulb is converted into blue and green light. The blue and green light passing through the NBI filter can arrive sequentially because of the RGB rotating filter. A wide-band RGB filter is installed here, and when the B filter is connected to the optical path, only narrow-band blue light can pass through. Similarly, when the G filter is connected to the optical path, only narrow-band green light can be used as observation light to irradiate from the front end of the endoscope.
Features and Advantages
NBI technology effectively displays the morphology of superficial mucosal capillaries and tree-like vessels, improves the contrast between vascular images and surrounding tissues, highlights the morphology of mucosal capillaries, and improves the doctor's ability to judge lesions.
In NBI mode, superficial capillaries can be displayed asbrownand tree-like vessels under the mucosal surface aredark greenthus distinguishing the location of superficial capillaries from deeper vessels.The lesioned mucosa is richly vascularized, and the distribution of capillaries on the mucosal surface is altered, which is more obvious under NBI observation.
Narrow-band imaging (NBI) technology has the following advantages:
1. No need for endoscopic spraying of contrast dye;
2. Avoiddue touneven dye distributionleading to misjudgment of the lesion;
3. Able to quickly switch between traditional endoscopic imaging and NBI imagingquickly switchfor easy comparison observation of the lesionrepeated comparative observation；
4. Formucosal microvascular morphologyhas unique advantages;
5. It can more easily detectflat or small lesionsto guide biopsy and improve the detection rate of precancerous lesions and early gastric cancer;
6. Simple operationwith shortened time, reducing patient discomfort during examination;
7. Clear imagereducing the possibility of diagnosis being affected by operation.
Clinical Application
Currently, NBI technology has been applied to multiple clinical fields, in addition to the digestive tract, including otorhinolaryngology, respiratory tract, gynecological endoscopy and laparoscopic surgery. Among them, the clinical application in the digestive tract mainly includes the following three aspects:
1. Early detection and diagnosis of small lesions;
2. Combined withmagnification endoscopyto observe its fine structure, further evaluate its characteristics andpredict the histopathologicalresults;
3. As a lesiontargeted biopsyandendoscopic treatmentoflocalizationmethods to improve the positive rate of biopsy.
Summary
The application of NBI technology has greatly improved the diagnosis and detection rate of early digestive tract lesions. Compared with traditional endoscopic staining methods, it reduces the examination time, reduces the suffering of the examinees, and also reduces the fatigue and difficulty of the physician's work. In the next issue, we will introduce another electronic chromoendoscopy technology -FICEandLasereotechnology.
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