Neue Techniken der modernen Endoskopie

Zusammenfassung

Die moderne Medizin ist geprägt durch die Entwicklung der Computer- und Chiptechnologie mit den damit verbundenen neuen Möglichkeiten der Bildgebung. Einen führenden Stellenwert in der Gastroenterologie nimmt hierbei die Entwicklung neuer bildgebender Verfahren in der Endoskopie ein. Hauptziel der Endoskopie ist die frühe Erkennung maligner Veränderungen, um diese rechtzeitig noch vor Auftreten einer Metastasierung endoskopisch zu resezieren. Die Diagnostik prä- und frühmaligner Veränderungen im Gastrointestinaltrakt bestimmt dabei unmittelbar die Prognose der betroffenen Patienten. Dazu stehen heute neben der Chromoendoskopie neue Techniken und Verfahren wie die High-Definition-Endoskopie oder die virtuelle Chromoendoskopie zur Verfügung. Alternativ versuchen sich neue Methoden wie die Autofluoreszenz oder die Spektroskopie als neue Verfahren zu etablieren, andere Techniken wie die konfokale Endomikroskopie haben bereits den Weg in die endoskopische Untersuchung als In-vivo-Histologie bereits erfolgreich gefunden. Verfahren wie die molekulare Bildgebung werden ex vivo bereits erfolgreich eingewendet und stehen kurz vor ihrem Durchbruch, auch in der Routine Anwendung zu finden.

Abstract

Computer and chip technologies have faced major technological advances that can improve endoscopic diagnostics. New image modalities and techniqiues are the most important facotors in modern endoscopy today. The prognosis for patients with malignancies of the gastrointestinal (GI) tract is strictly dependent on early detection of premalignant and malignant lesions. Chromoendoscopy or filter-aided colonoscopy (virtual chromoendoscopy) with High Definition endoscopes can enhance detection and characterization of lesions. Finally confocal laser endomicroscopy can provide histological confirmation to define whether neoplastic changes are present or not and autofluorescence and spectroscopy are becoming more and more important. Molecular imaging is already ex vivo possible and first attempts were made to introduce this technique in a daily routine.

Schlüsselwörter

moderne Endoskopie - High-Definition-Endoskopie - virtuelle Endoskopie - Autofluoreszenz - Endomikroskopie - molekulare Bildgebung

Key words

modern endoscopy - high definition endoscopy - virtual chromoendoscopy - autofluorescence - endomicroscopy - molecular imaging

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