In vivo pilot study into superficial microcirculatory characteristics of colorectal adenomas using novel high-resolution magnifying endoscopy with blue laser imaging

World J Gastrointest Endosc. 2024 Apr 16;16(4):206-213. doi: 10.4253/wjge.v16.i4.206.

Abstract

Background: No studies have yet been conducted on changes in microcirculatory hemodynamics of colorectal adenomas in vivo under endoscopy. The microcirculation of the colorectal adenoma could be observed in vivo by a novel high-resolution magnification endoscopy with blue laser imaging (BLI), thus providing a new insight into the microcirculation of early colon tumors.

Aim: To observe the superficial microcirculation of colorectal adenomas using the novel magnifying colonoscope with BLI and quantitatively analyzed the changes in hemodynamic parameters.

Methods: From October 2019 to January 2020, 11 patients were screened for colon adenomas with the novel high-resolution magnification endoscope with BLI. Video images were recorded and processed with Adobe Premiere, Adobe Photoshop and Image-pro Plus software. Four microcirculation parameters: Microcirculation vessel density (MVD), mean vessel width (MVW) with width standard deviation (WSD), and blood flow velocity (BFV), were calculated for adenomas and the surrounding normal mucosa.

Results: A total of 16 adenomas were identified. Compared with the normal surrounding mucosa, the superficial vessel density in the adenomas was decreased (MVD: 0.95 ± 0.18 vs 1.17 ± 0.28 μm/μm2, P < 0.05). MVW (5.11 ± 1.19 vs 4.16 ± 0.76 μm, P < 0.05) and WSD (11.94 ± 3.44 vs 9.04 ± 3.74, P < 0.05) were both increased. BFV slowed in the adenomas (709.74 ± 213.28 vs 1256.51 ± 383.31 μm/s, P < 0.05).

Conclusion: The novel high-resolution magnification endoscope with BLI can be used for in vivo study of adenoma superficial microcirculation. Superficial vessel density was decreased, more irregular, with slower blood flow.

Keywords: Adenoma; Blue laser imaging; High-resolution magnification endoscopy; Microcirculation.