Efficacy of I-scan endoscopy in the diagnosis of gastroesophageal reflux disease with minimal change

Min Sik Kim, Seok Reyol Choi, Myung Hwan Roh, Jong Hun Lee, Jin Seok Jang, Byung Geun Kim, Sang Ock Kim, Ji Sun Han, Chien Ter Hsing, Min Sik Kim, Seok Reyol Choi, Myung Hwan Roh, Jong Hun Lee, Jin Seok Jang, Byung Geun Kim, Sang Ock Kim, Ji Sun Han, Chien Ter Hsing

Abstract

Background/aims: The aim of the study was to evaluate the efficacy of i-scans for the diagnosis of gastroesophageal reflux disease, especially where only minimal change is involved.

Methods: The esophageal mucosa was inspected using an i-scan following conventional white light endoscopy. The examination with iscan was performed under tone enhancement (TE) esophagus (e) mode. Patients with subtle distal esophageal mucosal changes without definite mucosal breaks, such as blurring of Z-line (B), mucosal coarseness (C), hyperemic or purplish discoloration (D), erythema (E), ectopic gastric mucosal islet (I) and mixed type were classified as minimal change.

Results: A total of 156 patients were included. Using i-scan endoscopy, the number of minimal change was found to further increase from 94 (conventional endoscopy; 19B, 9C, 29D, 13E, 5I, 19 mixed type) to 109 (i-scan; 15B, 8C, 29D, 16E, 5I, 36 mixed type). And 14 patients who had single type by conventional endoscopy were converted to mixed type after i-scan. Therefore, 29 of 156 patients were upgraded after i-scan, they were account for 19% (p<0.0001; 95% confidence interval, 0.13 to 0.25).

Conclusions: The use of i-scan endoscopy significantly improves the identification of minimal change and helps to identify more precisely the type of minimal change.

Keywords: Gastroesophageal reflux; I-scan; Minimal change.

Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Endoscopic findings. Comparison between conventional and i-scan tone enhancement (TE) esophagus (e) method in erythema of minimal change. (A) In conventional endoscopic examination, normal mucosa of esophagus was shown. (B) Erythema of minimal change was detected in i-scan endoscopic examination.
Fig. 2
Fig. 2
Endoscopic findings. Comparison between conventional and i-scan tone enhancement (TE) esophagus (e) method in mixed type of minimal change. (A) Only blurring of minimal change was shown in conventional endoscopic examination. (B) In i-scan endoscopic examination, ectopic gastric mucosal islet was more detected.

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