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. 2013;2013:580526.
doi: 10.1155/2013/580526. Epub 2013 Aug 6.

Narrow Band Imaging With Magnification Endoscopy for Celiac Disease: Results From a Prospective, Single-Center Study

Free PMC article

Narrow Band Imaging With Magnification Endoscopy for Celiac Disease: Results From a Prospective, Single-Center Study

L De Luca et al. Diagn Ther Endosc. .
Free PMC article


In celiac disease (CD), the intestinal lesions can be patchy and partial villous atrophy may elude detection at standard endoscopy (SE). Narrow Band Imaging (NBI) system in combination with a magnifying endoscope (ME) is a simple tool able to obtain targeted biopsy specimens. The aim of the study was to assess the correlation between NBI-ME and histology in CD diagnosis and to compare diagnostic accuracy between NBI-ME and SE in detecting villous abnormalities in CD. Forty-four consecutive patients with suspected CD undergoing upper gastrointestinal endoscopy have been prospectively evaluated. Utilizing both SE and NBI-ME, observed surface patterns were compared with histological results obtained from biopsy specimens using the k-Cohen agreement coefficient. NBI-ME identified partial villous atrophy in 12 patients in whom SE was normal, with sensitivity, specificity, and accuracy of 100%, 92.6%, and 95%, respectively. The overall agreement between NBI-ME and histology was significantly higher when compared with SE and histology (kappa score: 0.90 versus 0.46; P = 0.001) in diagnosing CD. NBI-ME could help identify partial mucosal atrophy in the routine endoscopic practice, potentially reducing the need for blind biopsies. NBI-ME was superior to SE and can reliably predict in vivo the villous changes of CD.


Figure 1
Figure 1
(a, b, and c) Normal villous patterns. Visualization of normal duodenal mucosa at white light SE (a). Regular villi appear well represented, thick, with a finger-like appearance at NBI system and ME (b and c). (d, e, and f) Abnormal villous patterns. Partial villous atrophy view at SE (d); NBI-ME showing a low-density of villi which appear irregular, disoriented, and with an initial pattern of surface destruction (e and f). (g, h, and i) Absent villous patterns. Marked villous atrophy with NBI system and ME (g); the surface is flat (h), “foveolar-like,” with total villi absence and wide circles (i: black arrow).
Figure 2
Figure 2
Receiver operating characteristic curves of NBI-ME and SE for diagnosing CD.

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