- Moises Guelrud, MD
Moises Guelrud, MD
- Clinical Professor of Medicine
- Tufts University School of Medicine
- Elissa E Kaplan, MD
Elissa E Kaplan, MD
- GI Health Care Associates
- Newton-Wellesley Hospital
The ability to magnify endoscopic images in real-time (magnification endoscopy) permits visualization of mucosal details that cannot be seen with standard endoscopy. The images can be further enhanced by the topical application of stains or pigments (enhanced magnification endoscopy or magnification chromoscopy).
Equipment and experience with these approaches is evolving. A growing number of reports suggest that they offer the ability to improve diagnostic accuracy for a variety of gastrointestinal disorders . In addition, newer technologies, such as confocal laser endomicroscopy and endocytoscopy, are now allowing for real-time visualization of the gastrointestinal tract at a microscopic level [2,3].
Magnification endoscopy will be reviewed here. Other methods for enhanced visualization of the gastrointestinal mucosa are discussed elsewhere. (See "Chromoendoscopy" and "Barrett's esophagus: Evaluation with narrow band imaging".)
Magnification endoscopes include an adjustable focusing mechanism that permits standard endoscopic views and the ability to enlarge the image from 1.5X to 150X [4,5]. Several different models are commercially available. The newest magnification endoscopes permit magnification without loss of resolution.
Resolution is related to pixel density. Conventional endoscopes have pixel densities in the range of 100,000 to 200,000. By contrast, the newest magnification endoscopes have pixel densities from 850,000 to more than 1 million, allowing them to discriminate objects that are only 10 to 71 microns in diameter [1,5].
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