High-resolution optical coherence tomographic imaging of osteoarthritic cartilage during open knee surgery.

High-resolution optical coherence tomographic imaging of osteoarthritic cartilage during open knee surgery.
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开放膝盖手术期间骨关节炎软骨的高分辨率光学相干断层扫描成像。

DOI:
10.1186/ar1491
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发表时间:
2005
影响因子:
4.9
通讯作者:
Brezinski, Mark E
Brezinski, Mark E
中科院分区:
医学2区
文献类型:
--
作者:
Li, Xingde;Martin, Scott;Pitris, Costas;Ghanta, Ravi;Stamper, Debra L;Harman, Michelle;Fujimoto, James G;Brezinski, Mark E

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这项研究证明了第一个实时成像的人体软骨在正常和骨关节炎的膝关节在微米的分辨率,使用光学相干断层扫描(OCT)。这种最近开发的高分辨率成像技术类似于B型超声,只是它使用红外光而不是声音。在膝关节开放手术期间,使用便携式OCT系统和手持式成像探头对6名患者进行了11 μm分辨率、每秒4帧的实时成像。通过在成像前标记部位实现组织配准,然后进行组织学处理。结构变化,包括软骨变薄,裂缝,和原纤维化,观察到的分辨率远远高于目前的临床成像技术。OCT检测到的结构特征在相应的组织学中是明显的。除了结构形态的变化,OCT还观察到关节软骨的双折射或偏振特性的变化,表明胶原蛋白紊乱,这是骨关节炎的早期指标。此外,这项研究支持了这样的假设:偏振敏感OCT可以在软骨变薄之前诊断骨关节炎。这项研究表明,OCT,它最终可以开发用于办公室或通过关节镜,具有相当大的潜力,评估早期骨关节炎软骨和监测软骨修复的治疗效果与分辨率在真实的时间在微米级。
This study demonstrates the first real-time imaging in vivo of human cartilage in normal and osteoarthritic knee joints at a resolution of micrometers, using optical coherence tomography (OCT). This recently developed high-resolution imaging technology is analogous to B-mode ultrasound except that it uses infrared light rather than sound. Real-time imaging with 11-μm resolution at four frames per second was performed on six patients using a portable OCT system with a handheld imaging probe during open knee surgery. Tissue registration was achieved by marking sites before imaging, and then histologic processing was performed. Structural changes including cartilage thinning, fissures, and fibrillations were observed at a resolution substantially higher than is achieved with any current clinical imaging technology. The structural features detected with OCT were evident in the corresponding histology. In addition to changes in architectural morphology, changes in the birefringent or the polarization properties of the articular cartilage were observed with OCT, suggesting collagen disorganization, an early indicator of osteoarthritis. Furthermore, this study supports the hypothesis that polarization-sensitive OCT may allow osteoarthritis to be diagnosed before cartilage thinning. This study illustrates that OCT, which can eventually be developed for use in offices or through an arthroscope, has considerable potential for assessing early osteoarthritic cartilage and monitoring therapeutic effects for cartilage repair with resolution in real time on a scale of micrometers.