Volume 135, Issue 6, Pages (December 2008)

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Presentation transcript:

Volume 135, Issue 6, Pages 1870-1876 (December 2008) In Vivo Confocal Endomicroscopy in the Diagnosis and Evaluation of Celiac Disease Rupert W.L. Leong, Nam Q. Nguyen, Christopher G. Meredith, Sam Al–Sohaily, Darko Kukic, Peter M. Delaney, Elise R. Murr, Jim Yong, Neil D. Merrett, Andrew V. Biankin Gastroenterology Volume 135, Issue 6, Pages 1870-1876 (December 2008) DOI: 10.1053/j.gastro.2008.08.054 Copyright © 2008 AGA Institute Terms and Conditions

Figure 1 Superficial CEM imaging showing (A) normal small intestinal villi, (B) villous atrophy, (C) normal deep imaging, and (D) crypt hypertrophy. For illustrative purposes (E) normal villi and (F) crypt hypertrophy on scanning electron microscopy are shown. White arrows denote crypt openings. All CEM images are shown at 1000-fold magnification. Gastroenterology 2008 135, 1870-1876DOI: (10.1053/j.gastro.2008.08.054) Copyright © 2008 AGA Institute Terms and Conditions

Figure 2 ROC curves, area under curve (auc) with 95% confidence intervals, sensitivity and specificity of CEM in the diagnosis of VA, CH, and combined parameters in comparison with (A) a true diagnosis of CD and (B) histologic features of CD. Gastroenterology 2008 135, 1870-1876DOI: (10.1053/j.gastro.2008.08.054) Copyright © 2008 AGA Institute Terms and Conditions

Figure 3 Correlation of the confocal celiac score with the Marsh grading of severity of CD (R-squared, 0.756). A CCS of 0.06 or higher indicates a true diagnosis of CD whereas the threshold of detectable histopathologic features of CD is a CCS of 0.22 or higher. Gastroenterology 2008 135, 1870-1876DOI: (10.1053/j.gastro.2008.08.054) Copyright © 2008 AGA Institute Terms and Conditions

Figure 4 The discriminate ability of the median CCS, their interquartile ranges (iqr) in differentiating controls from treated CD patients and untreated CD patients in identifying crypt hypertrophy and the Kruskal–Wallis test P values. Gastroenterology 2008 135, 1870-1876DOI: (10.1053/j.gastro.2008.08.054) Copyright © 2008 AGA Institute Terms and Conditions