Missed Diagnosis Rate Research Articles

Radiographic evaluation of the distal tibiofibular syndesmosis injury in ankle fractures

Objective To compare the X-ray and CT manifestations of ruptured distal tibiofibular syndesmosis coupled with ankle fracture for better diagnosis of lower tibiofibular syndesmosis injury.Methods A retrospective study was performed of 36 patients who had been treated in our department for ankle fracture complicated with distal tibiofibular syndesmosis injury from January 2009 to December 2011.They were 16 men and 20 women,18 to 67 years of age (average,41.9 years).They all had anterior-posterior X-ray and CT examinations preoperatively.The clear gaps and lower tibiofibular distances 10 mm above the tibial astragaloid joint were measured respectively on X-ray films and CT scans.The differences were compared between positive X-ray clear gaps and CT lower tibiofibular distances.Results The mean X-ray clear gap 10 mm above the tibial astragaloid joint was 7.95 ± 0.49 mm while the mean CT lower tibiofibular distance 10 mm above the tibial astragaloid joint was 8.48 ± 0.41 mm.The difference was significant (t =-3.376,P =0.002).The ankle mortise was less than 6 mm in 6 X-ray films,giving a rate of missed diagnosis of 16.7％ while the lower tibiofibular distance was hess than 6 mm in 2 CT scans,giving a rate of missed diagnosis of 5.67％.The difference was significant (x2 =2.250,P =0.034).Conclusions Both standard X-ray imaging and CT scan can detect ankle fracture complicated with separation of distal tibiofibular syndesmosis,but CT may lead to a reduced rate of missed diagnosis compared with X-ray,displaying the situation of distal tibiofibular syndesmosis injury more precisely and clearly. Key words: Ankle; Fracture; Joint instability; X-Ray, diagnostic; Computerized tomography

GW24-e2160 Clinical feature of cor triatriatum in 23 cases

ObjectivesTo summarise the data of clinical feature, accompanied abnormities and imaging diagnosis of cor triatriatum in 23 cases enlisted in the study.MethodsFrom January 1993 to June 2005, twenty-three patients, 13...

Comparison of ultrasonography and magnetic resonance imaging in diagnosis of breast cancer

Objective To compare the clinical diagnostic value of ultrasound and magnetic resonance imaging (MRI) in breast cancer.Methods Ultrasound and MRI were performed in patients with breast disease.The postoperative pathological examination results were seemed as diagnostic criteria.The diagnostic accuracy was analyzed in two kinds of imaging examination.Results The diagnostic accuracy of MRI in breast cancer(86.9％) was significantly higher than the accuracy of ultrasonic diagnosis(39.3％),the sensitivity and specificity of MRI were significantly higher than those in ultrasonic diagnosis,the rate of missed diagnosis and misdiagnosis rate of MRI were lower than those of ultrasonic diagnosis,the differences were statistically significant (x2 =6.583,12.573,4.892,23.175,8.649,all P ＜ 0.05).Conclusion Ultrasound and MRI have high ability in diagnosis of breast cancer.MRI diagnostic efficacy has more advantages,but the ultrasound is convenient to operate and repeate inspection,can be used in screening. Key words: Ultrasonography; Magnetic resonance imaging; Breast neoplasms

Diagnostic value of ultrasound for ectopic pregnancy

Objective To explore the diagnostic value of color Doppler ultrasonography and ultrasonography in the differential diagnosis of ectopic pregnancy.Methods 142 patients with ectopic pregnancy were given ultrasonic examination,to observe whether intrauterine gestational sac,carefully looking for recognition of ovarian masses and distinguish the relationship and structure,and were compared with pathologic diagnosis.Results Ultrasound could clearly display the uterus,ovary,failed to break the gestational sac and blood(block) mass image structure,with pathological diagnosis coincidence rate was 95.1％ (135/142),the misdiagnosis rate was 1.4％ (2/142),the missed diagnosis rate of 3.5％ (5/142).Conclusion Ultrasound was rapid,simple,noninvasive,high-accuracy,it was the preferred method for early diagnosis of the ectopic pregnancy. Key words: Ultrasonography; Pregnancy, ectopic

Clinicopathological features of Wilson disease: report of 29 cases

To summarize the clinicopathological manifestations of Wilson disease(WD) so as to improve its recognition. A total of 29 WD cases were retrospectively analyzed, including clinical presentations, liver function test, serum ceruloplasmin, 24 hour urinary copper excretion, ATP7B gene analysis and liver histology. All cases were diagnosed from January 2007 to October 2012 at Third Hospital of Hebei Medical University and China-Japan Friendship Hospital. There were 18 males and 11 females with an average age of 25.9 years. The major clinical symptoms included fatigue (n = 18, 62.1%), abdominal distension (n = 4,13.8%) and pruritus (n = 4, 13.8%). The common physical signs were hepatomegaly (n = 11, 37.9%), splenomegaly(n = 15, 51.7%) and ascites (n = 4, 13.8%). The laboratory examinations included abnormal liver function (n = 29, 100%), high level of 24-hour urinary copper excretion (n = 29, 100.0%), low serum ceruloplasmin (n = 24, 82.8%) and Kayser-Fleischer ring (n = 8, 27.6%). ATP7B gene mutations were at exons 5, 8, 11, 12, 16 and 18. The earliest histologic abnormalities of liver included steatosis (both microvesicular and macrovesicular). Timm's stain showed positive or negative staining. There was no or focal hepatocellular necrosis in liver. During chronic hepatitis phase, the major changes included inflammatory cells infiltration in portal area with biliary epithelium degeneration. The periportal area hepatic cells were swollen, cytoplasm slightly stained and accompanied with some copper particles deposition and cholestic changes. There were many spotty or focal lesion of necrosis in liver. During cirrhotic phase, portal area became enlarged by fibrotic tissue, numerous copper particles deposited in wide fibrous septa and small bile ducts were damaged and became proliferative. Hepatocytes around fibrous interval showed cholestatic changes and contained many copper particles. They diagnosed on the basis of clinical presentation(n = 6), clinical presentation and liver histology (n = 4) and clinical presentation, liver histology and gene analysis (n = 19). There is a high misdiagnosis rate of WD based solely on clinical presentation. Cholestic changes around fibrous interval are common histologic features. The most common ATP7B gene mutations are compound heterozygotes in exons 16. Comprehensive evaluations of clinical presentation, liver histology and gene analysis are helpful for early diagnosis and timely treatment so that it helps to reduce the misdiagnosis and missed diagnosis rate of WD.

ASSA13-17-9 Clinical Feature of Cor Triatriatum in 23 Cases

<h3>Objective</h3> To summarise the data of clinical feature, accompanied abnormities and imaging diagnosis of cor triatriatum in 23 cases enlisted in the study. <h3>Methods</h3> From January 1993 to June 2005, twenty-three patients, 13 males and 10 females with a mean age of (9.6 ± 10.0) years (range 0.3 from 38 years) were studied. All cases were cor triatriatum laevus. Twenty-one of 23 patients were identified in surgery. Complete cor triatriatum in 15 case and incomplete cor triatriatum in 6. Electrocardiogram show that right unsymmetrical cardial axle was in 18 patients and nomal cardial axle in 4. Eight cases had lung congestion in x-ray. <h3>Results</h3> Echocardiogram diagnosed 12 in 23 cases before surgery. Heart catheter exam diagnosed 4 in 10 cases. sixteen of 21 cases accompanied other abnormities. Main malformations included atrial septal defeat (n = 14), partial anomalous pulmonary venous drainage (n = 6), pulmonary stenosis (n = 3), persistent left superior vena cava (n = 3). Seven of 21 patients had no atrial septal defeat. <h3>Conclusions</h3> cor triatriatum had great variation in clinical feature and complicated other malformations in high ratio. Color doppler imaging has high worthiness of diagnosis of cor triatriatum, but misdiagnosis and missed diagnosis rate is high in cor triatriatum accompanied other malformations. Heart catheter exam have missed diagnosis to cor triatriatum, but have higher diagnosis rate to accompanied abnormities. Surgical exploration is very important in cor triatriatum accompanied other malformations.

Early Access to a Neurologist Reduces the Rate of Missed Diagnosis in Young Strokes

We hypothesized that the presence of an in-house neurologist or a neurology or emergency medicine (EM) residency is associated with a lower rate of missed stroke diagnosis and a greater use of thrombolytic therapy. The outpatient Young Stroke registry from our academic medical center was reviewed. Patients 16 to 50 years of age who presented with ischemic stroke were included. Information on presentation, acute therapy, and missed diagnosis was obtained. The presence of an EM or neurology residency at the presenting hospital was recorded. We also assessed whether hospital teaching status in these fields affected missed diagnosis rates, the use of thrombolysis, or stroke intervention. Ninety-three patients were included. Thirteen patients were misdiagnosed. In hospitals with and without a neurology residency, the missed diagnosis rate was 6.3% versus 18.0%, respectively (P=.21). Two patients were misdiagnosed in hospitals with a neurology residency, but neither had neurology consultations in the emergency department. If these cases are removed from our analysis, the rate of missed diagnosis with and without a neurology residency is 0% versus 20.6%, respectively (P=.008). Acute stroke therapy was administered in 17.9% of patients seen with an EM residency, compared to 2.7% without an EM residency (P=.046). With and without a neurology residency, acute stroke therapy was administered in 25% versus 8.2% of cases, respectively (P=.055). Young adults with ischemic stroke seen at hospitals with a neurology residency had a lower missed diagnosis rate. The presence of an EM resident or a neurology teaching program was associated with a greater use of acute stroke therapies. These results support initiatives to triage young adults with suspected acute stroke to hospitals with access to neurologic expertise in the emergency department.

Clinical analysis of 20 cases of synchronous multi-primary esophageal carcinomas

To explore the clinicopathologic findings, endoscopic features and preoperative diagnostic rates of synchronous multi-primary esophageal carcinomas. A total of 602 inpatients were diagnosed as esophageal carcinomas from January 1990 to April 2012. According to Warren's criteria, 20 cases of synchronous multi-primary esophageal carcinomas were enrolled. There were 13 males and 7 females with a mean age of (62 ± 11) years at the onset of diagnosis. Clinicopathologic features and diagnostic methods were studied retrospectively. There were a total of 45 synchronous multi-primary esophageal carcinomas. Most lesions occurred in middle and lower thoracic esophagus (40 lesions, 88.9%) and were of fungating type (27 lesions, 60.0%) under endoscopy. Histologically the most common type was squamous cell carcinoma (36 lesions, 80.0%). Eleven cases of upper gastro-enterography (n = 15) and 6 cases of endoscopy (n = 11) were miss-diagnosed respectively. Because of a high rate of missed diagnosis, a clinician should be aware of multi-esophageal carcinomas. It is important to perform upper gastro-enterography, abdominal computed tomography and endoscopy conscientiously to improve the diagnosis.

CLINICAL CHARACTERISES OF 224 CASES WITH NORMOKALEMIC AND HYPERTENSIVE PRIMARY ALDOSTERONISM

ObjectivesTo investigate the clinical characteristics of patients with normokalemic and hypertensive primary aldosteronism.MethodsThe clinical data of 224 cases with normokalemic and hypertensive primary aldosteronism from 2006 to 2010 in the...

Lengthened proximal femoral nail antirotation for femoral shaft fractures combined with ipsilateral femoral neck fractures

Objective To investigate the methods and results of lengthened proximal femoral nail antirotation (PFNA) in the treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Methods Of the 21 patients with femoral shaft combined with ipsilateral femoral neck fractures treated by lengthened PFNA from 2006 to 2009,16 patients with complete follow-up were retrospectively studied.There were 15 males and 1 female,at mean age of 35 years (range,21-51 years).Injury causes were all high-energy trauma including traffic injuries in 11 patients and fall injuries in five.According to Garden classification,there were seven patients with type Ⅰ femoral neck fractures,six with type Ⅱ and three with type Ⅲ.Femoral shift fractures contained six superior part fractures and nine medial part fractures and one inferior part fracture.According to Winquist classification,there were two patients with type Ⅰ femoral shaft fractures,four with type Ⅱ,six with type Ⅲ and four with type Ⅳ.Two patients had open fractures belonging to type Ⅰ Gustilo-Anderson.Harris hip score was used to evaluate functional outcomes at the last follow-up postoperatively. Result The mean follow-up time was 2.4years (range,1-4 years ).The mean period for healing of femoral neck and shaft fractures was 4.2months ( range,3-6 months) and 5.1 months ( range,3-8 months) respectively.Four patients showed delayed diagnoses of femoral neck fractures ; two patients had delayed union of femoral shaft fractures ; one suffered from avascular necrosis of the femoral head ; one patient presented 3 cm of extension of the affected limb and was accompanied by active pain of the knee joint for over four months.According to Harris score,function of hip joints was excellent in seven patients,good in six and fair in three,with excellence rate of 82％. Conclusions It is relatively few that the femoral shaft fracture is combined with ipsilateral femoral neck fracture.The rate of missed diagnosis of femoral neck fractures is high and the patients with high energy trauma hould be highly paid attention to.Lengthened PFNA conforms to characteristics of biomechanical fixation and presents short operation time and solid fixation. Lengthened PFNA achieves affirmatory effects for treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Key words: Femoral fractures; Femoral neck fractures; Fracture fixation,internal

Value of echocardiography in the diagnosis of aortico-left ventricular tunnel

Objective To evaluate the clinical value of echocardiography in the diagnosis of aorticoleft ventricular tunnel.Methods The echocardiographic and clinical characteristics were retrospectively analyzed in 6 patients with aortico-left ventricular tunnel we reported and 147 cases that documents reported.Results Six patients were confirmed by operation.The main echocardiographic characteristics of aortico-left ventricular tunnel were as follows:An abnormal communication began in the ascending aorta above the level of the coronary arteries,bypassed the aortic valve,and terminated in the left ventricle.The color Doppler flow imaging demonstrated to-and-fro flow,with or without aortic valve involvement.According Hovaguimian and his colleagues,2 cases were type Ⅰ,2 cases were type Ⅲ,1 case was type Ⅳ,1 case was type Ⅱ (showed as recanalization).Base on all of the 153 patients that we and documents reported,the accuracy rate of ultrasound diagnosis was 79.6％,the misdiagnosis rate was 17.1％,and missed diagnosis rate was 3.3 ％.Conclusions Echocardiography is the non-invasive and sensitive tool in the diagnosis of the type of aortico-left ventricular tunnel and structure of cardiac involvement,and is the preferred method for preoperative. Key words: Echocardiography; Heart defects,congenital; Aortico-left ventricular tunnel

Review article: Late post‐hysterectomy ectopic pregnancy

Ectopic pregnancy after hysterectomy is a rare but potentially life-threatening condition requiring prompt diagnosis to prevent the increased mortality associated with rupture. Twenty-seven cases of late post-hysterectomy ectopic pregnancy reported in the English literature since 1918 were reviewed and analysed for presenting symptoms, missed diagnosis rate at initial presentation, location of ectopic and rupture rate at diagnosis. The presenting symptoms were found to be non-specific. The diagnosis in this population is twice more likely to be missed than in women with intact uteri. The rupture rate is 63%, compared with 37% in women with intact uteri. The majority of late post-hysterectomy ectopic pregnancies (62%) were located in the fallopian tubes. Because of the potential risk of mortality, emergency physicians should always consider the possibility of ectopic pregnancy in childbearing women whose surgical history includes hysterectomy without oophorectomy. Evaluation of abdominal pain in this population should include a pregnancy test to ensure prompt diagnosis when the possibility of pregnancy exists clinically.

Clinical analysis of 47 cases of synchronous double primary carcinomas of esophagus and cardia

To explore the clinical features and prognosis of the patients with synchronous double primary malignancy of esophagus and cardia. The clinical data of patients with synchronous primary esophageal and cardiac carcinomas undergoing surgery at our hospital between April 1988 and April 2009 were retrospectively reviewed. All data were analyzed by the SPSS 15.0 software. The overall survival rates (OS) were calculated and compared with the Kaplan-Meier method and the Log-rank test. The prognostic factors were identified by Cox's hazard regression model. Among all 47 cases, esophageal carcinoma was missed preoperatively in 1 patients and cardiac carcinoma in 12. The 1-, 3- and 5-year overall survival rates (OS) of the whole group were 81.5%, 49.1% and 34.3% respectively. And the median survival time was 33 months. The univariate analysis of prognostic factors showed that radical resection, N stage of esophageal carcinoma (2009), N stage of cardiac carcinoma (2009) and TNM stage of cardiac carcinoma (both 2002 and 2009) might influence the long-term survival. However, according to the multivariate analysis, only radical resection and N stage of cardiac carcinoma (2009) were independent prognostic factors. With preoperative combined examination of esophagography and esophagoscopy and thorough intraoperative detection, the clinicians may reduce the rate of missed diagnosis for synchronous double primary esophageal and cardiac carcinomas. Radical resection of primary lesions and thorough dissection of locoregional lymph nodes may improve the patient survival.

Will computed tomography (CT) miss something? The characteristics and pitfalls of torso CT in evaluating patients with blunt solid organ trauma

Selective nonoperative management has become the Standard care for blunt solid organ trauma patients, and torso computed tomography (CT) provides useful therapeutic clues. We conducted this study to determine the frequency and character of missed diagnoses in blunt solid organ trauma patients. We reviewed the medical records of all blunt trauma patients who underwent torso CT and who were admitted for solid organ injuries (liver, spleen and kidney) at the Chi- Mei Medical Center from August 2003 to October 2006. The patients were divided into the Missed Group (24 patients) and the Unaltered Group (262 patients) according to the presence or absence of a missed diagnosis. The overall missed diagnosis rate was 8.4%. Only one unidentified bowel injury was disclosed by follow-up CT, and all of the missed injuries were revealed by laparotomy. The Missed Group had a higher Injury Severity Score, lower Glasgow Coma Scale, more Intensive Care Unit (ICU) care, and longer duration of hospitalization. Discovery of missed diagnoses is not uncommon in patients who sustain severe trauma. Laparotomy revealed all of the missed diagnoses, and follow-up CT demonstrated a poor ability to detect unidentified injuries. We suggest laparotomy instead of follow-up CT in the nonoperative management of patients with blunt solid organ injuries if clinical deterioration occurs.

Diagnostic value of B type ultrasound in ureteral calculi

Objective To evaluate the diagnostic value of B type ultrasound in ureteral calculi. Methods B type ultrasound examination were performed on 100 cases with ureteral calculi who were confirmed by open surgery, extracorporeal shock wave lithotripsy and comprehensive therapy. Results The diagnostic accuracy was 94. 00% in 100 cases,no false positive was found,and the rate of missed diagnosis was 6.00% (6 cases). Conclusion B type ultrasound has a high application value in the diagnosis of ureteral calculi, which has low false positive rate and can clear display negative stone. It can also afford some accurate clues for diagnosis and clinical treatment in tihe according to abdomenal B type ultrasound and it will be preferred in way for diagnosis of acute nephrite colic especially in basic hospitals. Key words: Ureteral calculi; B type ultrasound; Missed diagnosis

Prospective clinic study of decreasing the rate of missed diagnosis of endometrial cancer

to analyze the clinical significance of a novel operating approach of cutting the core of uterus to perform freezing section histological examination intra-operatively for the patients with endometrial hyperplasia (EH). the patients ready to undergo total hysterectomy with a histological diagnosis of EH were selected. In the cutting core group (n = 39), the core of uterus was resected firstly according to the freezing histological diagnosis. Thirty cases received hysteroscopy with directed biopsies while the control group had 57 cases. Their differences of missed diagnosis rate of endometrial cancer and operative approaches were compared. And the clinic significance of cutting firstly the core of uterus intra-operatively was discussed. in the cutting core, hysteroscopy with directed biopsies and control groups, the missed diagnosis rate was 2.6%, 3.3% and 14.0% respectively. The missed diagnosis rate of first two groups had significant difference as compared with the controls (χ(2) = 4.78, P < 0.05; χ(2) = 4.73, P < 0.05). the novel operating approach can effectively prevent the missed diagnosis of endometrial cancer. It helps a surgeon to choose suitable operative extent for the patients with endometrial hyperplasia.

Rate and risk factors of missed diagnosis of colorectal adenoma with colonoscopy

Objective To investigate the miss rate of adenoma with colonoscopy and assess the features and risk factors for missed diagnosis.Methods Patients with colorectal adenoma received a second colonoscopy within 120 days after adenoma was detected and removed on the initial colonoscopy.The findings of two colonoscopies were reviewed and analyzed.The features of adenoma （including size, location, shape, number and pathology） , clinical characteristics of patients （including age, sex, reasons of colonoscopy, history of diverticular disease, history of abdominal or pelvic surgery and colonoscopy with sedation） and endoscopists were recorded.Miss rate and features of different types of missed adenoma were analyzed.We also assessed the effects of adenoma features, patients＇ characteristics and endoscopists on missed diagnosis of adenoma.Results Adenoma missed diagnosis was found in 271 patients out of 809 recruited subjects （33% ）.A total of 425 adenomas were missed out of 2134 （20% ） adenomas detected by repeated colonoscopy.A large diameter was associated with a decrease in the miss rate for adenoma （P 〈 0.01）.Conversely , sessile or flat shape （P 〈 0.01） , locations at sigmoid, hepatic flexure, cecum and ascending colonic （ P 〈 0.05） were significantly associated with a higher miss rate of adenoma, as was the number of adenomas （P 〈0.01）.A higher adenoma missed diagnosis rate was observed in beginner colonoscopists, as compared with experienced ones （P 〈 0.01）.Conclusion A marked miss rate of adenoma exists on colonoscopy, which is significantly associated with the size, shape, location and number of adenomas and endoscopists. Key words: Colonoscopy; Adenomatous polyposis coli; Miss rate

Value of emergency bedside ultrasound in diagnosis of blunt abdominal trauma

Objective To discuss the value of emergency bedside ultrasound in diagnose of blunt abdominal injury. Methods Portable ultrasound was used in 184 patients with blunt abdominal trauma in emergency department. The abnormal changes of the sound and image of the abdomen were observed,paying equal attention to free intraperitoneal fluid and gas. Results The emergency bedside ultrasound identified 169 (91.8%) patients with blunt abdominal injury, of whom 149 patients (95.5%) with single-organ injury and 20 patients (71.4%) with multi-organ injury. There were 21 patients missed diagnosis and three misdiagnosed, with rate of missed diagnosis and misdiagnosis of 13%. Surgical treatment was performed in 119 patients and conservative treatment in 65, which were proved by CT/MRI examination or clinic conservative treatment. Conclusion Emergency bedside ultrasound can provide fast and credible diagnostic information for blunt abdominal trauma, with high diagnosis accordance rate. Key words: Abdominal injuries, closed; Ultrasonography, Doppler, color; Emergency treatment

Diagnostic Value of B-type Ultrasound for intraocular foreign bodies and missed diagnosis in 126 inpatient cases

Objective To evaluate the roles of diagnosing intraocular foreign bodies (IOFB) and missed diagnosis with B-type ultrasound. Methods Retrospective study of 126 clinic inpatient cases. Results The rate of metallic foreign body(MFB) was 74.6%, the rate of intraocular foreign body was 81.8 %, the rate of intraorbital foreign body was 7.1%; The missed diagnosis rate of B-type ultrasound for intraocular foreign bodies was 1.6%, the discovering rates were decreased for anterior segment and retrobulbar intraocular foreign bodies,and the showing rate was high to the vitreous opacity and retinal detachment caused by intraocular foreign bodies. Conclusion Type ultrasound can provide the required information on diagnosis and surgery design of IOFB. Small intraocular metal foreign bodies are easily misdiagnosed and missed diagnosed. Routine examination including B-type ultrasound for patients who had symptoms of intraocular foreign bodies, can obviously reduce the misdiagnosis and missed diagnosis. Key words: Intraocular foreign bodies(IOFB); B-type ultrasound; Analysis; Missed diagnosis

Comparison of autofluorescence imaging （AFI） and white light （WL） endoscopy in screening of colon polyps

Objective To compare the detective rates of colonic polyps with autofluorescence ima- ging （AFI） and white light （WL） endoscopy. Methods A total of 562 patients, who underwent colonosco- py for screening of colon polyps, were recruited from December 2008 to April 2009 and randomized into 2 groups. All patients received 2 times of colonoscopy. For those in group A, the colonoscopy was inserted to cecum and withdrawn to rectum at WL mode in first examination, and the scope was inserted again into ce- cum under WL mode and withdrawn to rectum at AFI mode. For those in group B, the withdrawal procedures were performed reversely. Biopsies were performed at the first discovery of polyps as a marker. Location, shape and size of the polyp were recorded. All biopsy specimens were histopathologically examined. Results In group A, 78 polyps were detected under WL mode and 28 additional in AFI. In group B, 106 polyps were detected in AFI and 20 additional in WL. The rate of missed diagnosis of AFI for all polyps （ 15.9% ） was significantly lower than that of WL （26. 4%, P = 0.041 ）. Conclusion AFI endoscopy is sensitive in detection of colonic polyps and easy to manipulate, which is useful in screening of colon polyps. Key words: Intestinal polyps ; Autofluorescence imaging