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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(06): E781-E787
DOI: 10.1055/a-2306-9218
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Novel physiological analysis using blood flow velocity for colonic polyps: Pilot study

Eiji Kamba
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Takashi Murakami 
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Naoki Tsugawa
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Kei Nomura
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Keiichi Haga
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Yoichi Akazawa 
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Hirofumi Fukushima
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Hiroya Ueyama 
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Kenshi Matsumoto
2   Department of Gastroenterology, Nihonbashi Muromachi Mitsui Tower Midtown Clinic, Tokyo, Japan
,
Tomoyoshi Shibuya
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Takeshi Terai
3   Department of Gastroenterology, Terai Clinic, Tokyo, Japan
,
Takashi Yao
4   Department of Human Pathology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
,
Akihito Nagahara
1   Department of Gastroenterology, Juntendo University, Bunkyo-ku, Japan (Ringgold ID: RIN12847)
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Abstract

Real-time visualization of red blood cell flow inside subepithelial microvessels is performed with magnifying endoscopy. However, microvascular blood flow velocity in the colorectum has not been investigated. Here, we aimed to evaluate the blood flow velocity of microvessels of colonic polyps and to compare it with that of surrounding mucosa. We examined 50 lesions, including 30 adenomas (ADs) and 20 hyperplastic polyps (HPs). Blood flow velocities of lesions and their surrounding mucosa were evaluated using magnifying blue laser imaging (BLI) prior to endoscopic resection. Calculation of mean blood flow velocities was based on mean movement distance of one tagged red blood cell using split video images of magnifying BLI. Mean microvascular blood flow velocity was significantly lower in ADs (1.65±0.66 mm/sec; range 0.46–2.90) than in HPs (2.83±1.10 mm/sec; 1.07–4.50) or the surrounding mucosa (3.73±1.11 mm/sec; 1.80–6.20; P <0.001). The blood flow velocity rate compared with the surrounding mucosa was significantly lower in ADs (0.41±0.16; 0.10–0.82) than in HPs (0.89±0.25; 0.46–1.51; P <0.001). We found that mean microvascular blood flow velocity was significantly lower in ADs than in HPs and the surrounding non-neoplastic mucosa. These findings indicate that a novel dynamic approach with microvascular blood flow velocity using magnifying endoscopy may be useful in assessing physiological differences between ADs and HPs.

Keywords

Endoscopy Lower GI Tract - Polyps/adenomas/... - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...) - Tissue diagnosis


Publication History

Received: 12 November 2023

Accepted after revision: 27 March 2024

Accepted Manuscript online:
15 April 2024

Article published online:
18 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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