Understanding Real-Time Fluorescence Signals from Bacteria and Wound Tissues Observed with the MolecuLight i:Xâ„¢
Understanding Real-Time Fluorescence Signals from Bacteria and Wound Tissues Observed with the MolecuLight i:Xâ„¢
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DOI：
10.3390/diagnostics9010022
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发表时间：
2019-02-26
期刊：
影响因子：
3.6
通讯作者：
Linden, Ron
中科院分区：
文献类型：
--
作者：
Rennie, Monique Y.;Dunham, Danielle;Linden, Ron
病原菌的持续存在是伤口愈合的主要障碍之一。伤口细菌的检测依赖于采样方法，这会延迟几天的确认。然而，一种新型的手持式荧光成像设备最近已经能够基于其固有荧光特性实时检测伤口中的细菌，该固有荧光特性不同于背景组织的固有荧光特性。该器械用紫光（405 nm）照射伤口，使组织和细菌产生内源性特征荧光信号，这些信号被过滤并实时显示在器械屏幕上。由此产生的图像允许快速评估和记录中到重负荷下荧光细菌的存在、位置和程度。这些信息已被证明有助于伤口评估和指导患者特定的治疗计划。然而，正确的图像解释是必不可少的评估这一信息。为了正确识别细菌荧光区域，用户必须理解：（1）来自组织的荧光信号（例如，伤口组织、腱、骨）和流体（例如，血、脓）;（2）来自细菌的荧光信号（红色或青色）;（3）改变组织和细菌荧光的色调的基本原理;（4）可能出现的图像伪影;以及（5）来自非生物材料的一些潜在混淆信号（例如，荧光清洁溶液）。因此，本教程为临床医生提供了识别常见伤口荧光特征的基本原理。临床示例旨在帮助临床医生进行图像判读，重点关注图像伪影和图像判读的潜在混淆因素，并建议如何在临床实践中对伤口进行成像时克服这些挑战。
The persistent presence of pathogenic bacteria is one of the main obstacles to wound healing. Detection of wound bacteria relies on sampling methods, which delay confirmation by several days. However, a novel handheld fluorescence imaging device has recently enabled real-time detection of bacteria in wounds based on their intrinsic fluorescence characteristics, which differ from those of background tissues. This device illuminates the wound with violet (405 nm) light, causing tissues and bacteria to produce endogenous, characteristic fluorescence signals that are filtered and displayed on the device screen in real-time. The resulting images allow for rapid assessment and documentation of the presence, location, and extent of fluorescent bacteria at moderate-to-heavy loads. This information has been shown to assist in wound assessment and guide patient-specific treatment plans. However, proper image interpretation is essential to assessing this information. To properly identify regions of bacterial fluorescence, users must understand: (1) Fluorescence signals from tissues (e.g., wound tissues, tendon, bone) and fluids (e.g., blood, pus); (2) fluorescence signals from bacteria (red or cyan); (3) the rationale for varying hues of both tissue and bacterial fluorescence; (4) image artifacts that can occur; and (5) some potentially confounding signals from non-biological materials (e.g., fluorescent cleansing solutions). Therefore, this tutorial provides clinicians with a rationale for identifying common wound fluorescence characteristics. Clinical examples are intended to help clinicians with image interpretation-with a focus on image artifacts and potential confounders of image interpretation-and suggestions of how to overcome such challenges when imaging wounds in clinical practice.