Three-dimensional reconstruction of the mucosa from sequential sections of biopsy specimens of patients with ulcerative colitis: Relationship between crypt structure and vascular architecture

Background:  In a previous paper, the stereographic reconstruction of the crypt structure of ulcerative colitis using the RATOCK System was described. The relationship between the blood vessels and the crypt structure is the focus of the current paper, using two kinds of tissue staining color in which the color differs. Stereographic images make the relationship between the crypt structure and blood vessel distribution understandable at a glance. Methods:  The methods used here are identical to those described in a previous paper. In the present paper, five cases of ulcerative colitis (UC) are examined. Biopsy specimens were obtained from the diseased, normal, and transitional zones (the area between the normal and diseased zones) from each patient. Three-dimensional reconstruction was created using TRI for Windows (RATOC System Tokyo, Japan) software. In the present paper, two kinds of dyeing method between H&E and monoclonal antibody staining of the tissue was used. It was proven that the distribution of gland and blood vessel is very clear in the 3-D reconstruction shown. Results:  (i) The blood vessels in the normal zones run parallel to the crypt in a regular manner and are almost identical to one another in diameter. (ii) In the transitional and diseased zones, the blood vessels show no clear direction and produce many branches without any apparent order. The blood vessels are, moreover, irregular in diameter. (iii) In short, clear parallelism is lost in both the transitional and diseased zones. Conclusion:  Stereographic reconstruction of endoscopically obtained biopsy specimens of UC-affected tissues makes it possible to understand at a glance the distribution of blood vessels and their relationship to crypts. The relationship of these was clarified by the combined use of two kinds of dyeing method with three-dimensional reconstruction.