Accuracy of virtual chromoendoscopy in differentiating gastric antral vascular ectasia from portal hypertensive gastropathy:A proof of concept study

作     者：Ahmad M Al-Taee Mark P Cubillan Alice Hinton Lindsay A Sobotka Alex S Befeler Christine Y Hachem Hisham Hussan 

作者机构：Division of Gastroenterology and HepatologyNYU Langone HealthNew YorkNY 10016United States Department of Internal MedicineSaint Louis UniversitySt LouisMO 63110United States Division of BiostatisticsThe Ohio State UniversityColumbusOH 43210United States Division of GastroenterologyHepatologyand NutritionThe Ohio State UniversityColumbusOH 43210United States Division of Gastroenterology and HepatologySaint Louis UniversitySt LouisMO 63110United States 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第12期

页      面：2168-2178页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Portal hypertensive gastropathy Gastric antral vascular ectasia Virtual chromoendoscopy Endoscopy 

摘      要：BACKGROUND Accurate detection of gastric antral vascular ectasia(GAVE)is critical for proper management of cirrhosis-related gastrointestinal ***,endoscopic diagnosis of GAVE can be challenging when GAVE overlaps with severe portal hypertensive gastropathy(PHG).AIM To determine the added diagnostic value of virtual chromoendoscopy to high definition white light for real-time endoscopic diagnosis of GAVE and *** We developed an I-scan virtual chromoendoscopy criteria for diagnosis of GAVE and *** tested our criteria in a cross-sectional cohort of cirrhotic adults with GAVE and PHG when high-definition white light endoscopy(HDWLE)diagnosis was in *** then compared the accuracy of I-scan vs HDWLE alone to *** Twenty-three patients were included in this study(65.2%Caucasians and 60.9%males).Chronic hepatitis C was the predominant cause of cirrhosis(43.5%)and seven adults(30.4%)had confirmed GAVE on histology.I-scan had higher sensitivity(100%vs 85.7%)and specificity(75%vs 62.5%)in diagnosing GAVE compared to *** translates into a higher,albeit not statistically significant,accuracy of I-scan in detecting GAVE compared to HDWLE alone(82%vs 70%).I-scan was less likely to lead to an accurate diagnosis of GAVE in patients on dialysis(P0.05)and in patients with elevated creatinine(P0.05).Iscan had similar accuracy to HDWLE in detecting *** This pilot work supports that virtual chromoendoscopy may obviate the need for biopsies when the presence of GAVE is in *** studies are needed to assess the impact of virtual chromoendoscopy on success of endoscopic therapy for GAVE.