ĸ½¶³»½Ã°æ°ú ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æÀÇ ¼ÒÀ庴º¯ÀÇ Áø´Ü ÀÏÄ¡µµ
Diagnostic Agreement between Capsule Endoscopy and Double-balloon Enteroscopy of Small Bowel Disease

´ëÇѼÒÈ­±â³»½Ã°æÇÐȸÁö 2010³â 40±Ç 4È£ p.236 ~ p.243

±èÇö°Ç(Kim Hyun-Gun) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±èÁø¿À(Kim Jin-Oh) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ¼ÒÈ­±â¿¬±¸¼Ò
ÀÌÅÂÈñ(Lee Tae-Hee) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±è¿ÏÁß(Kim Wan-Jung) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ÃÖÇö¼÷(Choi Hyun-Sook) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Á¶¿µ°ü(Cho Young-Kwan) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Á¶¿ø¿µ(Cho Won-Young) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
°íºÀ¹Î(Ko Bong-Min) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Á¶ÁÖ¿µ(Cho Joo-Young) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç, ¼ÒÈ­±â¿¬±¸¼Ò
À̹®¼º(Lee Moon-Sung) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç, ¼ÒÈ­±â¿¬±¸¼Ò
ÀÌÁؼº(Lee Joon-Seong) - ¼øõÇâ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç, ¼ÒÈ­±â¿¬±¸¼Ò

Abstract

¸ñÀû: ĸ½¶³»½Ã°æ°ú ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æÀ» ¸ðµÎ ½ÃÇàÇÑ ¼ÒÀåÁúȯÀÌ ÀÇ½ÉµÈ È¯ÀÚµéÀ» ´ë»óÀ¸·Î º´º¯ °üÂûÀÇ ÀÏÄ¡µµ¿¡ ´ëÇØ ¾Ë¾Æº¸°íÀÚ ÇÏ¿´´Ù.

´ë»ó ¹× ¹æ¹ý: 2005³âºÎÅÍ 2009³â 4¿ù±îÁö ĸ½¶³»½Ã°æ°ú ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æ°Ë»ç¸¦ ¸ðµÎ ½ÃÇà¹ÞÀº 30¸íÀ» ´ë»óÀ¸·Î º´¼Ò ¹ß°ßÀ²°ú º´º¯ ÀÏÄ¡µµ, Áø´Ü ÀÏÄ¡µµ µîÀ» ÈÄÇâÀûÀ¸·Î ºñ±³ ºÐ¼®ÇÏ¿´´Ù.

°á°ú: 30¸í(M£º17, F£º13)ÀÇ Æò±Õ ¿¬·ÉÀº 45¡¾17¼¼¿´À¸¸ç 24¸íÀº Ç÷º¯ ¹× Èæ»öº¯, ºóÇ÷À» ÁÖ¼Ò·Î, 6¸íÀº º¹ÅëÀ» ÁÖ¼Ò·Î ¼ÒÀå º´º¯¿¡ ´ëÇÑ °Ë»ç¸¦ ½ÃÇà¹Þ¾Ò´Ù. ¼ÒÀå º´º¯¿¡ ´ëÇÑ Áø´ÜÀ²Àº ĸ½¶³»½Ã°æ 56.7%(17/30¸í), ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æ 73.3%(22/30¸í)¿´À¸¸ç, µÎ °Ë»ç¸¦ ¸ðµÎ ½ÃÇà¹ÞÀº ÈÄ Áø´ÜÀ²Àº 93.3%(28/30¸í)À̾ú´Ù. ĸ½¶³»½Ã°æ¿¡¼­ Á¤È®ÇÑ Áø´ÜÀÌ ¾î·Á¿ü´ø 13¿¹ Áß 61.5%(8/13)¿¡¼­ ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æÀ» ½ÃÇàÇÏ¿© Á¤È®ÇÑ Áø´ÜÀ» ³»¸± ¼ö ÀÖ¾ú´Ù. ĸ½¶³»½Ã°æ°ú ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æÀÇ º´º¯ °üÂû¿¡ ´ëÇÑ ºñ±³¿¡¼­´Â ÁߵÀÇ ÀÏÄ¡µµ¸¦ º¸¿´À¸¸ç(kappa=0.484), Áõ»óÀÇ À¯¹ßÀÌ °¡´ÉÇØ º¸ÀÌ´Â µ¿ÀÏ º´º¯À» °üÂûÇÑ ¿¹´Â ÀüüÀÇ 56.6%(17/30¸í)À̾ú´Ù. µ¿ÀÏÇÑ º´º¯ÀÌ °üÂûµÈ 17¿¹ Áß Ä¸½¶³»½Ã°æ¿¡¼­ Áø´ÜÀÌ ¾Ö¸ÅÇÏ¿© ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æ ½ÃÇà ÈÄ Áø´ÜÀÌ ¹Ù²ï °æ¿ì´Â 5.9%(1/17¿¹)·Î ¸ßÄ̾¾ °Ô½Ç 1¿¹¿´À¸¸ç, µ¿ÀÏ º´º¯ÀÌ °üÂûµÇÁö ¾Ê¾Æ Áø´ÜÀÌ ¹Ù²ï ¿¹´Â 36.7%(11/30¿¹)·Î À̵é 11¿¹ Áß Ä¸½¶³»½Ã°æ¿¡¼­ º´º¯ °üÂûÀÌ ¾Ö¸ÅÇϰųª Áø´ÜÀÌ ¾î·Á¿ü´ø °æ¿ì°¡ 81.8%(9/11¿¹)¿´´Ù.

°á·Ð: µÎ °Ë»çÀÇ ¼ÒÀå º´º¯¿¡ ´ëÇÑ °üÂû ºñ±³¿¡¼­´Â ÁߵÀÇ ÀÏÄ¡µµ¸¦ º¸À̸ç, ĸ½¶³»½Ã°æÀº ¼öµ¿ÀûÀÎ °üÂûÀ» Çϱ⠶§¹®¿¡ ½Ã¾ß°¢¿¡¼­ ÇÑ ¹ø¿¡ °üÂûÀÌ ¾î·Á¿î º´º¯Àº Áø´ÜÀÌ ¾î·Á¿ï ¼ö ÀÖ´Ù. µû¶ó¼­ ĸ½¶³»½Ã°æ¿¡¼­ °üÂûµÈ º´º¯ÀÌ Áõ»óÀ» ¼³¸íÇϱ⿡ ¸ðÈ£ÇÒ °æ¿ì¿¡´Â ÀÓ»óÀûÀÎ ÆÇ´Ü¿¡ µû¶ó ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æÀ» ½ÃÇàÇÑ´Ù¸é ¼ÒÀå º´º¯¿¡ ´ëÇÑ Áø´ÜÀ²À» ³ôÀÏ ¼ö ÀÖÀ» °ÍÀ¸·Î »ý°¢ÇÑ´Ù.
Background/Aims: To evaluate the diagnostic agreement between capsule endoscopy (CE) and double-balloon enteroscopy (DBE) in patients with suspected small bowel disease.

Methods: We retrospectively analyzed and compared the diagnostic yield and the diagnostic agreement between CE and DBE, in patients who initially underwent CE followed by DBE at a single tertiary referral center.

Results: Thirty patients (17 males, mean age 45¡¾17) underwent both CE and DBE. Total small bowel examination was possible in 80% (24/30) with CE, and 20% (6/30) with DBE. Diagnostic yield was 56.7% (17/30) with CE, and 73.3% (22/30) with DBE. Overall diagnostic yield was 93.3% (28/30) after both examinations. The overall degree of concordance between CE and DBE for lesion description was a moderate agreement, with a calculated kappa index of 0.48 (95% CI 0.44¡­0.52, p£¼0.05). Both CE and DBE detected identical lesions relevant to the clinical presentation in 56.6% (17/30) of cases. A total of 36.7% (11/30) of cases changed diagnosis because different lesions were detected by each method.

Conclusions: The overall degree of concordance between CE and DBE showed moderate agreement. Additional DBE examinations can improve the diagnostic yield of small bowel lesions in patients with no relevant findings or failed detection on CE, who are, however, clinically suspicious.

Å°¿öµå

ĸ½¶³»½Ã°æ, ÀÌÁßdz¼± ¼ÒÀå³»½Ã°æ, ÀÏÄ¡µµ
Capsule endoscopy, Double-balloon enteroscopy, Concordance
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
ÇмúÁøÈïÀç´Ü(KCI) KoreaMed ´ëÇÑÀÇÇÐȸ ȸ¿ø 
ÁÖÁ¦ÄÚµå
ÁÖÁ¦¸í(Target field)
¿¬±¸´ë»ó(Population)
¿¬±¸Âü¿©(Sample size)
´ë»ó¼ºº°(Gender)
Áúº´Æ¯¼º(Condition Category)
¿¬±¸È¯°æ(Setting)
¿¬±¸¼³°è(Study Design)
¿¬±¸±â°£(Period)
ÁßÀç¹æ¹ý(Intervention Type)
ÁßÀç¸íĪ(Intervention Name)
Å°¿öµå(Keyword)
À¯È¿¼º°á°ú(Recomendation)
¿¬±¸ºñÁö¿ø(Fund Source)
±Ù°Å¼öÁØÆò°¡(Evidence Hierarchy)
ÃâÆdz⵵(Year)
Âü¿©ÀúÀÚ¼ö(Authors)
´ëÇ¥ÀúÀÚ
DOI
KCDÄÚµå
ICD 03
°Ç°­º¸ÇèÄÚµå