Narrow band imaging (NBI) depicts distinct intramucosal vascular network and pit pattern without any use of dye technique. It is thus suggested that NBI can be used for the assessment of severity in inflammatory bowel diseases, especially in ulcerative colitis (UC). In the active UC, NBI colonoscopy depicts friability as a black area. In the inflamed granular mucosa, crypt openings and villous structure become evident through the procedure. In the inactive UC, there are two types of mucosal vascular pattern; one being composed of deep, green vessels and superficial, black vessels, and the other lacking in superficial vessels. With used of a magnifying instrument, the mildly active mucosa can be classified into the mucosa with obvious crypt openings and that with villous structure. Mucosal vascular pattern in the inactive mucosa is shown as a honeycomb-like structure or irregular, tortuous structure under magnifying NBI observation. Furthermore, such NBI findings show close correlations with histologic findings including crypt distortion, goblet cell depletion and basal plasmacytosis. Therefore, NBI colonoscopy might be of value for the precise assessment of histologic severity in mildly active and inactive UC.
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