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经典永流传-Pit Pattern分类,测一测你能否正确诊断?

2020-04-15 com0707 一泓小树林

经典永流传-Pit Pattern分类,测一测你能否正确诊断?

图1 Pit Pattern 放大色素内镜分类

图2 Pit Pattern 色素内镜分类

Pit Pattern I型

图3 结肠正常黏膜放大图像,可见圆形小pit,为正常隐窝。

Pit Pattern II型

图4 典型的 pit pattern II型,具有星形或洋葱皮状结构(左),II型开放 pit pattern由于黏液生成导致隐窝打开是SSA/P的特征(右)。

Pit Pattern IIIs型

图5 pit pattern III型由小的管状或圆形pits组成,比正常黏膜周围的隐窝小。

Pit Pattern IIIL型

图5 pit pattern IIIL型由长管状隐窝组成(左),有时在内部区域与正常隐窝混合在一起(右)。

Pit Pattern IV型

图6 pit pattern IV型为沟状、分支状或脑回样的表面结构。

Pit Pattern VI型

图7 pit pattern VI型与IIIL、IIIS和IV型类似,但由无序性、大小不等、不对称的腺管等组成。轻度不规则的称为“低级”(左),高度不规则的为“高级”(右)。

Pit Pattern VN型

图8 pit pattern VN型指表面结构丢失(左侧)或破坏(右侧) 。

Pit Pattern分类的意义

内镜诊断是内镜最重要的组成部分。使用放大内镜用于“Pit诊断”,更接近病理诊断。在Pit Pattern分类中,肿瘤与非肿瘤之间的正确诊断率约为96%~98%,腺瘤与癌症之间的正确识别率约为70%~90%。在黏膜下浸润癌中,血管浸润和淋巴结转移的风险与肿瘤的垂直浸润(T1)成正比。因此,在内镜下治疗早期结直肠癌之前,有必要对其浸润深度进行诊断。放大内镜显示,当作为Vn型黏膜下层侵犯的指标时,正确的识别率约为90%。因此,用放大内镜可以获得高精度的定性诊断。

白光+NBI


白光+NBI


白光+靛胭脂


白光内镜 CF-HQ290I


NBI CF-HQ290I


靛胭脂 CF-HQ290I

以下几张图片你的诊断是腺管分型?绒毛管状腺瘤或者TSA?

白光内镜 CF-H260I


NBI CF-H260I


靛胭脂 CF-H260I


NBI CF-H260I


甲紫染色 CF-H260I

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    2020-09-13 ms1000000302953060

    高压

    0

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