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Article 7, 3/2016


The Efficacy of Virtual Chromoendoscopy in the Diagnosis of Portal Hypertensive Gastropathy

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Anda Carmen Achim1, Stefan Cristian Vesa2, Eugen Dumitru1,3

1) Faculty of Medicine, Ovidius University Constanţa, Constanţa
2) Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca
3) Department of Gastroenterology, Clinical Emergency County Hospital Constanţa, Constanţa, Romania

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.253.chr

Background: Diagnosis of portal hypertensive gastropathy (PHG) is based on endoscopic criteria. I-scan technology, a new technique of virtual chromoendoscopy, increases the diagnostic accuracy for lesions in the gastrointestinal tract. Aim: To establish the role of i-scan endoscopy in the diagnosis of PHG.

Method: In this prospective study, endoscopic examination was conducted first by using white light and after that i-scan 1 and i-scan 2 technology in a group of 50 consecutive cirrhotic patients. The endoscopic diagnostic criteria for PHG followed the Baveno criteria. The interobserver agreement between white light endoscopy and i-scan endoscopy was determined using Cohen’s kappa statistics.

Results: Forty-five of the 50 patients met the diagnostic criteria for PHG when examined by i-scan endoscopy and 39 patients were diagnosed with PHG by white light endoscopy. The strength of agreement between the two methods for the diagnosis of PHG was moderate (k=0.565; 95%CI 0.271-0.859; p<0.001). I-scan 1 classified the mosaic pattern better than classic endoscopy; i-scan 2 described better the red spots.

Conclusion: I-scan examination increased the diagnostic sensitivity of PHG. The diagnostic criteria (mosaic pattern and red spots) were easier to observe endoscopically using i-scan than in white light.

Key words: portal hypertensive gastropathy – upper gastrointestinal endoscopy – i-scan.
Abbreviations: FICE: Fuji Intelligent chromoendoscopy; GAVE: gastric antral vascular ectasia; NBI: narrow band imaging; PHG: portal hypertensive gastropathy; PHT: portal hypertension; UGIB: upper gastrointestinal bleeding.