The role of clarifying endoscopic techniques in determining the degree of activity in patients with inflammatory bowel diseases

Aim. To identify the informative value of various signs when using virtual chromoscopy (VC) and autofluorescence (AFI) methods during an endoscopic examination to determine the severity of the inflammatory process in ulcerative colitis (UC) and Crohn’s disease (CD). Materials and methods. 151 patients with IBD were examined (51 with CD, 100 with UC). All patients underwent endoscopic colon examination using virtual chromoscopy and autofluorescence functions and taking biopsy material for histological examination. Results. With a minimum degree of UC, the absence of venules was revealed at VC (p<0.05), as well as green staining with foci of purple color at AFI (p<0.05). A moderate degree was characterized by visualization of the venules of the submucosal layer (p<0.001) and purple staining of the mucous membrane (MM) with foci of green color (p<0.001). The pronounced degree of inflammation of MM in AFI was diffusely colored purple (p<0.001), and the absence of two types of vascular pattern during VC (p<0.001). In CD, the infiltration phase was characterized by visualization of two types of green staining in AFI mode in comparable amounts, which was statistically significantly more common than other colors (p=0.033 and p=0.006). In the phase of ulcers with VC, we mainly determined the visualization of either capillaries or venules in the same amounts (p<0.001). In the scar phase, the frequency of occurrence of various types of staining in AFI was comparable to that in the remission phase and with the control group, in VC - both types of vascular pattern were detected with a significantly high frequency (p=0.001). Conclusion. Based on the results of the study, VC and AFI are additional methods in diagnostics of the degree of IBD activity and can be used in difficult cases to clarify the severity of inflammation in patients with UC and CD.

inflammatory bowel diseases, degree of inflammation activity, autofluorescence, virtual chromoscopy

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