诊断的准确性和观察者之间协定的胆管镜对于不确定的胆管狭窄:一个单一中心的经验
Sebastian Manuel Milluzzo1, Rosario Landi2, Vincenzo Perri2
1Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Lombardia, Italy.
概括
数字单操作器胆管透镜 (DSOC) 改善了不确定的胆管收缩 (IDBS) 的诊断. DSOC引导的活检具有高灵敏度和特异性,提高了对具有挑战性的胆道疾病的诊断准确性.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 内镜成像系统的成像
- 胆道疾病 胆道疾病
背景情况:
- 鉴定不确定的胆道狭窄症 (IDBS) 在诊断上具有挑战性.
- 传统的活检和刷取样在IDBS诊断方面存在局限性.
- 数字单操作者胆管透镜 (DSOC) 为改善可视化和采样提供了潜力.
研究的目的:
- 为了比较视觉评估和DSOC导向活检的诊断准确性,与IDBS的常规跨毛囊采样进行比较.
- 评估使用DSOC的视觉诊断的观察者间协议 (IOA).
主要方法:
- 在传统采样后,对接受IDBS的DSOC患者的回顾性评估.
- 基于手术样本组织学或6个月临床随访的最终诊断.
- 由IOA的专家和实习生审查的DSOC视频片段,使用摩纳哥分类进行分类.
主要成果:
- 通过改变狭窄位置,DSOC在21.4%的病例中提供了额外的诊断产量.
- DSOC引导的活检在技术上是成功的,具有92.8%的充分性,没有不良事件.
- 对于最终诊断,观察者之间高度一致 (kappa 0.871),视觉准确率为73.6% (专家) 和64.4% (实习生).
结论:
- DSOC可以提高无限期胆道狭窄的诊断准确度.
- DSOC对视觉发现具有很高的敏感性,对指导活检具有很高的特异性.
- 使用摩纳哥分类与DSOC的视觉诊断似乎是可靠的.
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