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Colonoscopy Principles and Practice - part 9

hiển vi huỳnh quang đồng tiêu của phần đông lạnh ngang mỏng của đại tràng bình thường (a), (b) polyp tăng sản và polyp tuyến (c) polyp niêm mạc minh họa sự khác biệt đáng kể trong nguồn autofluorescence và microdistributions trong mỗi loại của niêm mạc. | 526 Section 11 Neoplastic Detection and Staging New Techniques a c Fig. 44.12 Confocal fluorescence micrographs of frozen transverse thin sections of a normal colon b hyperplastic polyp and c adenomatous polyp mucosa illustrating significant differences in the autofluorescence sources and microdistributions in each type of mucosa. in combination to characterize the cellular origins of whole living colonic crypts and isolated living colonic epithelial cells derived from primary cell cultures of normal premalignant and malignant gastrointestinal tissues 53 . Inoue and colleagues 94 reported the use of CFM to obtain microscopic images from fresh specimens of gastrointestinal mucosa. Briefly untreated mucosal specimens from the esophagus stomach and colon obtained by endoscopic pinch biopsy polypectomy or endoscopic mucosal resection were fixed in normal saline and examined by CFM with 488 nm excitation in reflectance mode. Images were compared with conventional hematoxylin and eosin staining analyzing the nucleus-to-cytoplasm ratios. The overall diagnostic accuracy of CFM for cancer was 89.7 . The obvious advantages of blur-free fluorescence imaging and three-dimensional optical sectioning of ex vivo biologic tissues have made CFM an attractive concept for in vivo fluorescence endoscopic imaging. Recently a number of prototype confocal endoscopic devices have been described. Optiscan Inc. Victoria Australia introduced a fiberoptic confocal imaging FOCI for subsurface microscopy of the colon in vivo 95 . In combination with topically applied fluorescent dyes optical sections of the mucosal surface of the rat colon were made in vivo with the colon surgically exposed. A miniaturized scanning mechanism sweeps a 488-nm excitation laser beam across the tissue surface. Images with scanning speeds of up to 16 frames per second have a field of view ranging between 13 and 100 pm with optional zoom capabilities. The latest version of the FOCI device was used by the same group in