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The utility of narrow band imaging in improving the endoscopic diagnosis of gastroesophageal reflux disease.
Clin Gastroenterol Hepatol. 2009 Jan; 7(1):54-9.CG

Abstract

BACKGROUND & AIMS

Narrow band imaging (NBI) facilitates mucosal surface evaluation and may improve the endoscopic diagnosis of gastroesophageal reflux disease (GERD). We investigated the utility of NBI in improving the endoscopic diagnosis of GERD when compared with conventional endoscopy.

METHODS

A total of 107 subjects (nonerosive reflux disease [NERD], 36; erosive reflux disease [ERD], 41; controls, 30) were recruited prospectively. The mucosal morphology at the squamocolumnar junction (SCJ) in GERD and controls was visualized using conventional endoscopy and NBI. The main outcome measurements were as follows: (1) The differences in mucosal morphology at the SCJ between conventional endoscopy and NBI; and (2) the differences in mucosal morphology at the SCJ between GERD and controls with NBI.

RESULTS

Micro-erosions, increased vascularity, and pit patterns at the SCJ not seen on conventional endoscopy were well seen with NBI. Compared with controls, ERD and NERD had a significantly higher prevalence of micro-erosions (ERD, 100%; NERD, 52.8%; controls, 23.3%), and increased vascularity (ERD, 95.1%; NERD, 91.7%; controls, 36.7%), but a lower prevalence of round pit pattern (ERD, 4.9%; NERD, 5.6%; controls, 70%). ERD and NERD were similar in terms of increased vascularity and pit patterns. Increased vascularity with absence of round pit pattern was useful to distinguish NERD from controls (sensitivity, 86.1%; specificity, 83.3%). Interobserver agreement was good for increased vascularity (kappa = 0.95) and micro-erosions (kappa = 0.89), but lower for pit pattern (kappa = 0.59).

CONCLUSIONS

NBI enhanced mucosal morphology at the SCJ and appeared useful for improving the endoscopic diagnosis of GERD.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, Changi General Hospital, Singapore. kwong_ming_fock@cgh.com.sgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

18852068

Citation

Fock, Kwong-Ming, et al. "The Utility of Narrow Band Imaging in Improving the Endoscopic Diagnosis of Gastroesophageal Reflux Disease." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 7, no. 1, 2009, pp. 54-9.
Fock KM, Teo EK, Ang TL, et al. The utility of narrow band imaging in improving the endoscopic diagnosis of gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2009;7(1):54-9.
Fock, K. M., Teo, E. K., Ang, T. L., Tan, J. Y., & Law, N. M. (2009). The utility of narrow band imaging in improving the endoscopic diagnosis of gastroesophageal reflux disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 7(1), 54-9. https://doi.org/10.1016/j.cgh.2008.08.030
Fock KM, et al. The Utility of Narrow Band Imaging in Improving the Endoscopic Diagnosis of Gastroesophageal Reflux Disease. Clin Gastroenterol Hepatol. 2009;7(1):54-9. PubMed PMID: 18852068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The utility of narrow band imaging in improving the endoscopic diagnosis of gastroesophageal reflux disease. AU - Fock,Kwong-Ming, AU - Teo,Eng-Kiong, AU - Ang,Tiing-Leong, AU - Tan,Jessica Yi-Lyn, AU - Law,Ngai-Moh, Y1 - 2008/09/03/ PY - 2008/03/26/received PY - 2008/08/18/revised PY - 2008/08/21/accepted PY - 2008/10/15/pubmed PY - 2009/1/30/medline PY - 2008/10/15/entrez SP - 54 EP - 9 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 7 IS - 1 N2 - BACKGROUND & AIMS: Narrow band imaging (NBI) facilitates mucosal surface evaluation and may improve the endoscopic diagnosis of gastroesophageal reflux disease (GERD). We investigated the utility of NBI in improving the endoscopic diagnosis of GERD when compared with conventional endoscopy. METHODS: A total of 107 subjects (nonerosive reflux disease [NERD], 36; erosive reflux disease [ERD], 41; controls, 30) were recruited prospectively. The mucosal morphology at the squamocolumnar junction (SCJ) in GERD and controls was visualized using conventional endoscopy and NBI. The main outcome measurements were as follows: (1) The differences in mucosal morphology at the SCJ between conventional endoscopy and NBI; and (2) the differences in mucosal morphology at the SCJ between GERD and controls with NBI. RESULTS: Micro-erosions, increased vascularity, and pit patterns at the SCJ not seen on conventional endoscopy were well seen with NBI. Compared with controls, ERD and NERD had a significantly higher prevalence of micro-erosions (ERD, 100%; NERD, 52.8%; controls, 23.3%), and increased vascularity (ERD, 95.1%; NERD, 91.7%; controls, 36.7%), but a lower prevalence of round pit pattern (ERD, 4.9%; NERD, 5.6%; controls, 70%). ERD and NERD were similar in terms of increased vascularity and pit patterns. Increased vascularity with absence of round pit pattern was useful to distinguish NERD from controls (sensitivity, 86.1%; specificity, 83.3%). Interobserver agreement was good for increased vascularity (kappa = 0.95) and micro-erosions (kappa = 0.89), but lower for pit pattern (kappa = 0.59). CONCLUSIONS: NBI enhanced mucosal morphology at the SCJ and appeared useful for improving the endoscopic diagnosis of GERD. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/18852068/The_utility_of_narrow_band_imaging_in_improving_the_endoscopic_diagnosis_of_gastroesophageal_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(08)00901-4 DB - PRIME DP - Unbound Medicine ER -