32Vol. 37(1), Jan Gastroenterol Endosc 1995; 37: Hideyuki AKAI Observation and Evaluation of Esophageal Varices Before and After Sclerothe

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1 32Vol. 37(1), Jan Gastroenterol Endosc 1995; 37: Hideyuki AKAI Observation and Evaluation of Esophageal Varices Before and After Sclerotherapy by Infrared-Ray Electronic (TREE).

2 Figure 1 The diagram of computer analyzing system used for the analyzing of images through infrared rays electronic endoscope (IREE) with a laser diode light source.

3 Figure 5 The time cource of intensity (%) under infrared rays after intravenous administration of ICG in case of before sclerotherapy and after sclerotherapy.

4 Figure 6 The time cource of standard deviation index under infrared rays after intravenous administration of ICG in case of before sclerotherapy and after sclerotherapy. Figure 9 Recurrence rate of esophageal varices after sclerotherapy between cases under visible rays (dashed line, n=15) and infrared rays (solid line, N=15).

5 2. Kohso H, Tatsumi Y, Fujino H, Tokita K, Kodama T, Kashima K, Kawai K. An investigation of an infrared ray electronic endoscope with a laser diode light source. 1990; 22: Gibson LH, Buckley WR, Whitmore KE. New vistas in infrared photography for biological surveys. Journal of the Bio-logical Photographic Association 1965; 33: Cartwright CH. Infrared transmittance of the fresh. JOSA 1930; 20: Fox IJ, Wood EH. Indocyanine green: physical and physiologic properties. Staff Meetings of the Mayo Clinic 1960; 35:

6 9. Kodak Publication: N-1, Medical Infrared Photography. Easyman Kodak, Rochester , Kitano S, Koyanagi N, Higasi H, Sugimachi K. Prevention of reccurence of esophageal varices after endoscopic injection sclerotherapy with ethanolamine oleate. Hepatology 1987; 7: Figure 2 The region of interest in case of before sclerotherapy (a) and after sclerotherapy (b). Figure 3 Endoscopic views of esophageal varices under visible rays (a), under infrared rays before ICG administration (b), 30 second (c), 6 minute (d) after ICG administration. The esophageal varices and superficial vessels became more clearly under infrared rays after ICG administration than under visible rays. Figure 4 Endoscopic views of esophagus after sclerotherapy under visible rays (a), under infrared rays before ICG administration (b), 40 second (c), 2 minute (d) after ICG administration. The degree of enhancement of esophagus under infrared rays is lower after sclerotherapy than that before. Figure 7 The region of interest before ICG administration (a). 1 minute (b) after ICG administration in case of before sclerotherapy. The histogram of intensity on circular esophagus before ICG administration (c),1 minute (d) after ICG administration. Figure 8 The region of interest before ICG administration (a). 1 minute (b) after ICG administration in case of after sclerotherapy. The histogram of intensity on circular esophagus before ICG administration (c), 1 minute (d) after ICG administration.

7 OBSERVATION AND EVALUATION OF ESOPHAGEAL VARICES BEFORE AND AFTER SCLEROTHERAPY BY INFRARED-RAY ELECTRONIC ENDOSCOPY (IREE) Hideyuki AKAI, Hitoshi KHOSO, Yoshihide TATSUMI, Tadashi KODAMA AND Kei KASHIMA Third Department of Internal Medicine, Kyoto Prefectural University of Medicine. The images of esophageal varices by infrared rays electronic endoscope (TREE) with a laser diode light source under rapid intravenous administration of indocyanine green (ICG) were investigated. The contents studied were comparison of images between visible rays and infrared rays, and numerous evaluation of change of ICG enhancement in region of interest and histogram of circular esophagus by computer analysis. The subjects for this study were 15 cases performed initial endoscopic sclerotherapy, which were observed under infrared rays (IR) before and after sclerotherapy. Before sclerotherapy the esophageal varices and superficial vessels around varices were more cleary under IR after ICG administration than under visible rays. But after sclerotherapy the esophageal varices and superficial vessels were not seen and the degree of enhancement after ICG administration under IR became significantly lower after sclerotherapy than that before scierotherapy. Comparing the numerous evaluation of change of ICG enhancement between before and after sclerotherapy by computer analysis, reduction of enhancement was showed objectively. The histogram of circular esophagus after sclerotherapy, peak of intensity was reduced both before and after ICG administration, drawn more gently curved line than before sclerotherapy. These results suggested that TREE images after intravenous administration of ICG showed changes in the blood flow of esophageal varices and architecture of vascular system beneath the esophageal mucosa after sclerotherapy and the degree of ICG enhancement was able to be evaluated objectively by computer analysis. In prognosis after sclerotherapy, the difference between recurrence rate under infrared rays and visible rays was noted statistically significant (p <0.05). In conclusion, TREE is an useful method for precious observation of esophageal varices and evaluation of endoscopic sclerotherapy.

8 F Hideyuki Akaiほ か 論 文 附 図 本 文 掲 載 頁:p Figure-2 Figure-3 igure-7 Figure-4 Hiroaki Hosokaiほ か 論 文 附 図 本 文 掲 載 頁:p Figure-8

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