CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(08): E941-E949
DOI: 10.1055/a-0619-4965
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Objective evaluation of blood flow in the small-intestinal villous: quantification of findings from dynamic endoscopy with concomitant narrow-band imaging

Tomoaki Takeyama
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Yoshiki Hirooka
2  Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
,
Hiroki Kawashima
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Eizaburo Ohno
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Takuya Ishikawa
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Takeshi Yamamura
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Kazuhiro Furukawa
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Kohei Funasaka
2  Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
,
Masanao Nakamura
3  Department of Internal Medicine, Division of Therapeutic Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Ryoji Miyahara
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Masatoshi ishigami
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
,
Hidemi Goto
1  Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
› Author Affiliations
TRIAL REGISTRATION: Retrospective, Observational Single-Center Study UMIN000014200 at http://www.umin.ac.jp
Further Information

Publication History

submitted 23 November 2017

accepted after revision 09 April 2018

Publication Date:
01 August 2018 (online)

Abstract

Background and aims We have previously shown that the increase in blood flow volume in jejunum villi after spraying of 10 % dextrose solution correlates with pancreatic exocrine function (PEF). The aim of this study was to establish an objective method to evaluate the amount of jejunum villous blood flow using a novel image analysis system.

Patients and methods The subjects were 26 patients who underwent upper gastrointestinal endoscopy with a newly developed small intestine endoscope (SIF-Y0007, Olympus, Tokyo, Japan). By defining the ratio of capillary occupancy in each villus at levels from 1 to 5, villous blood flow was evaluated subjectively on the villous blood flow scale (VBFS). Objective evaluation was performed based on luminance analysis. The morphological opening process was used to make images with leveled brightness. A histogram was prepared from the luminance information and the standard deviation was determined and defined as SDOV (Standard Deviation calculated from a histogram made by luminance analysis Of Villi). PEF was evaluated by measuring the BT-PABA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid) excretion rate.

Results There was a significant positive correlation between VBFS and SDOV (P < 0.0001, ρ = 0.5882). SDOV was also positively correlated with PEF (P = 0.0004, ρ = 0.6421).

Conclusions SDOV is a new objective index for evaluation of blood flow volume in jejunum villi. SDOV may be useful in clinical practice to estimate PEF and for clarification of the mechanisms underlying the functional correlation between the pancreas and small intestine.