Das Mikroskop im Gastrointestinaltrakt: Konfokale Endomikroskopie – klinischer Nutzen und wissenschaftlicher Einblick in die Tiefe

 

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Zusammenfassung

Die Endomikroskopie erlaubt es erstmals, während der laufenden Endoskopie die Schleimhaut mikroskopisch zu untersuchen. Dafür ist die Applikation geeigneter Fluoreszenzfarbstoffe erforderlich. Indikation sind vor allem entzündliche und (prä-)neoplastische Erkrankungen, die durch ungezielte Biopsien häufig nur unvollständig erfasst werden können. Multiple Studien haben mittlerweile die Wertigkeit der Endomikroskopie im oberen und unteren Gastrointestinaltrakt etabliert. Folgestudien haben darüber hinausgehend die intravitale Mikroskopie des Gallengangs, der Leber und des Pankreas untersucht. Die Endomikroskopie ermöglicht außerdem erstmals die artefaktarme Untersuchung von Gewebe in dessen natürlicher Umgebung und weist damit einen völlig neuen Weg zu patientennaher Wissenschaft und molekularer Bildgebung. Sie verbindet somit die klinische Diagnostik mit der translationalen Wissenschaft.

Abstract

Endomicroscopy is a novel method that allows microscopy of the gastrointestinal mucosa during ongoing endoscopy. This necessitates the application of fluorescent contrast agents. Indications for endomicroscopy include inflammatory and (pre-)neoplastic diseases that are often only incompletely assessed by random biopsies. Multiple trials have established the value of endomicroscopy of the upper and lower gastrointestinal tract. Follow-up studies have evaluated intravital microscopy of the biliary tract, the liver or pancreas. Endomicroscopy for the first time enables microscopic imaging of the intact tissue virtually free of artifacts. This allows an unprecedented approach to the patient in gastrointestinal science and molecular imaging. CLE therefore links clinical patient care with translational science.

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