多模态内镜成像在消化道疾病诊疗中的研究 进展

Research Progress of Multimodal Endoscopic Imaging in the Diagnosis and Treatment of Digestive Diseases

摘要: 多模态内镜通过在同一成像平台中融合结构、功能及分子层面的信息，为消化道疾病的精准诊断与治疗提供了新的技术路径。光学相干断层成像(optical coherence tomography, OCT)、超声成像(ultrasound, US)、光声成像(photoacoustic imaging, PAI)及荧光成像(fluorescence imaging, FLI)等单一成像模态在分辨率、穿透深度及生物学特异性方面各具优势，但均存在难以全面反映病变多维特征的局限。近年来，以OCT-FLI和US-PAI为代表的多模态内镜系统在早期消化道肿瘤筛查、黏膜下病变评估、炎症活动监测及治疗过程导航中取得进展，可协同呈现组织结构、微血管功能及分子靶点等关键信息。尽管多模态内镜在探头微型化、系统集成、成像速度与临床标准化方面仍面临挑战，但以双模态方案为代表的部分系统已显示出较好的临床兼容性与转化潜力，而三模态及以上高阶系统仍以原型与探索研究为主。随着高性能器件、靶向分子探针以及人工智能重建与定量分析技术的发展，多模态内镜有望加速由研究原型向临床可用工具转化，为消化道疾病的精准诊疗提供更全面、实时的影像支持。

Abstract: Multimodal endoscopy provides a new technical approach for precise diagnosis and treatment of digestive diseases by integrating structural, functional, and molecular information within a single imaging platform. Single imaging modalities such as optical coherence tomography (OCT), ultrasound (US), photoacoustic imaging (PAI), and fluorescence imaging (FLI) each possess advantages in resolution, penetration depth, and biological specificity, but all have limitations in comprehensively reflecting the multi-dimensional characteristics of lesions. In recent years, multimodal endoscopic systems represented by OCT-FLI and US-PAI have made progress in early gastrointestinal tumor screening, submucosal lesion evaluation, inflammatory activity monitoring, and treatment navigation, enabling collaborative presentation of key information such as tissue structure, microvascular function, and molecular targets. Although multimodal endoscopy still faces challenges in probe miniaturization, system integration, imaging speed, and clinical standardization, some dual-modal systems have demonstrated good clinical compatibility and translational potential, while tri-modal and higher-order systems remain primarily in the prototype and exploratory research stage. With the development of high-performance devices, targeted molecular probes, and artificial intelligence-based reconstruction and quantitative analysis technologies, multimodal endoscopy is expected to accelerate the transformation from research prototypes to clinically available tools, providing more comprehensive and real-time imaging support for precise diagnosis and treatment of digestive diseases.