THREE-DIMENSIONAL RECONSTRUCTION OF THE MUCOSA FROM SEQUENTIAL SECTIONS OF BIOPSY SPECIMENS FOR UNDERSTANDING DISEASE PROGRESS IN ULCERATIVE COLITIS

Background: This paper describes the creation of 3-D computer graphic images of the mucosal crypt of ulcerative colitis (UC) and the resulting observations, which may have great significance to our understanding of the mechanisms involved in the progress of this disease. Methods: Endoscopic biopsy specimens of normal, diseased and transitional (the border area between normal and diseased) zones of the mucosa were taken from five different patients of various ages and at various periods in the progress of their diseases. Three-dimensional reconstruction of these specimens was perfomed using TRI for Windows (RATOC System Tokyo, Japan) as software. Results: Clear stereographic images exhibiting the structures of crypts, the effects and the progress of UC were obtained. It was seen that, (i) moving from normal to transitional and to diseased zones, the value for crypt volume and crypt surface area increased, but at a far lower rate than those representing the lumen volume and surface area, (ii) the numbers of crypts and crypt lumina decreased as inflammation became more severe and (iii) it is likely that there is a specific point (the intermediate portion of the crypt) which is attacked by inflammation in ulcerative colitis. Conclusion: This method, of stereographic analysis by computer, has opened a new door to the study of a whole range of inflammatory bowel diseases.