Usefulness of white-light imaging-guided narrow-band imaging for the differential diagnosis of small XXXX .

@entity1 @entity5 @entity75 @entity652 @entity694 @entity420
BACKGROUND: Small @entity5 and inflammatory lesions have similar endoscopic findings and are difficult to differentiate. Narrow-band imaging (NBI) can visualize microvessels and mucosal microstructure clearly and is widely used to diagnose early gastric and @entity694 . OBJECTIVE: To evaluate the usefulness of NBI for differentiating @entity5 from benign diseases. DESIGN: Retrospective cohort study. SETTING: Tertiary-care hospital. @entity1 : All 45 @entity1 who had suspicious @entity75 (enlarged or protruded morphology) during duodenoscopy and underwent NBI between March 2010 and January  2011. INTERVENTIONS: NBI. MAIN OUTCOME MEASUREMENTS: NBI images were assessed for irregular villous arrangement, irregular villous size, ridge disappearance, demarcation with normal villi, and abnormal microvasculature. Histology of NBI-guided lesion biopsy specimens provided the final diagnoses. Agreement between NBI images and histologic findings was analyzed. RESULTS: Of the 60 @entity75 , 11, 26, and 23 were @entity420 , @entity652 , and benign inflammatory diseases, respectively. Irregular villous arrangement, irregular villous size, ridge disappearance, demarcation with normal villi, and abnormal microvasculature were observed in 45%, 63%, 50%, 48%, and 58% of the lesions, respectively. Multivariate analysis revealed that irregular villous arrangement (odds ratio [OR] 15.76; 95% confidence interval [CI], 3.38-64.12; P  < .001) and abnormal microvasculature (OR 86.63; 95% CI, 14.56-515.41; P  < .001) were significant independent factors for identifying ampullary @entity652 and @entity420 . All @entity5 had at least one abnormal NBI feature. LIMITATIONS: Retrospective design. CONCLUSION: The NBI findings of irregular villous arrangement and/or abnormal microvasculature were useful for differentially diagnosing @entity5 . NBI may complement the accurate diagnosis of @entity75 by white-light imaging.
