1- Unidade de Gastrenterologia Pediátrica, CHULC - Hospital de Dona Estefânia
- ESPGHAN 51th Annual Meeting, Geneva, Switzerland, May 9-12, 2018.
- e-Poster - apresentação oral, 100 melhores posters, disponível no site da ESPGHAN.
- Abstract - J Pediatr Gastroenterol Nutr, Vol. 66, Supplement 2, page 145, April 2018
Objectives and Study: Background – Imaging systems such as NBI can be used in endoscopy and may affect its effectiveness. However, it’s crucial to take time to become acquainted with this new imaging system. Objective – To evaluate the use and utility of NBI in routine paediatric endoscopy.
Methods: Design – Retrospective study. Setting – Tertiary care centre. The endoscopic examinations using an “Olympus Evis Exera III” video imaging system and 190 series scopes, were reviewed. All examinations were performed by the authors. The patients and images that were evaluated with both NBI and white light imaging (WLI) were selected. Indication for endoscopy, endoscopic diagnosis, differences in mucosal morphology and vascularity between conventional endoscopy and NBI were evaluated. Histological findings were reviewed.
Results During a 2-year period, 409 patients were submitted to 536 upper endoscopies. Both NBI and WLI were used and compared in 316 upper endoscopies (59%). In the same period, 98 patients were submitted to 110 colonoscopies. In 21 (19%) both NBI and WLI were used and compared. Male/Female ratio was 1.19:1.0 and 1.58:1.0, and the mean age ± standard deviation (SD) was 9.8 ± 5.6 and 11.4 ± 5.6 years for upper endoscopy and colonoscopy, respectively. Oesophagus mucosa was evaluated with NBI in 299 examinations, being the most evaluated mucosa with this technique (95%). It was normal in 135 and had lesions in 164 (erosive reflux disease (ERD), 54; eosinophilic oesophagitis (EoE), 48; Barrett’s oesophagus, 21; ectopic gastric mucosa, 12; others, 29). Gastric mucosa was only evaluated with NBI in 15 examinations, being normal in 4 and with lesions in 11 (“gastritis”, 8; polyps, 3). Of the 34 duodenal examinations with NBI, 22 had normal mucosa and 12 had lesions (erosion and ulcer, 8; coeliac disease, 2; ectopic gastric mucosa, 1; polyps, 1). Of the 21 colonoscopies in which NBI was used, 13 had IBD with superficial erosions and the remaining had normal mucosa. Small mucosa breaks as well as oesophageal micro-erosions were more readily discerned with NBI, improving the endoscopic diagnosis of ERD and of EoE. Squamocolumnar junction and the presence of abnormal mucosal islands, Barrett’s oesophagus and ectopic gastric mucosa were visualized more precisely with NBI. The gastric and duodenum images obtained with NBI were of little practical use. NBI was useful for the diagnosis of IBD with normal mucosa seen with WLI, but with superficial erosions seen with NBI.
Conclusion: NBI improves the accuracy of endoscopic diagnosis and may be of interest in the diagnostic accuracy of oesophageal and colic disease in paediatric age, and probably will soon become an essential tool of endoscopic examination. Then, a standard education programme of NBI in paediatric endoscopy will be needed.
Key words: endoscopy, narrow band imaging (NBI), white light imaging (WLI).