Continuous blood flow visualization with laser speckle contrast imaging during neurovascular surgery.
Continuous blood flow visualization with laser speckle contrast imaging during neurovascular surgery.
复制标题
神经血管手术期间用激光斑点对比成像的连续血流可视化。
DOI：
10.1117/1.nph.9.2.021908
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发表时间：
2022-04
期刊：
影响因子：
5.3
通讯作者：
Dunn AK
中科院分区：
文献类型：
--
作者：
Miller DR;Ashour R;Sullender CT;Dunn AK
激光散斑对比成像(LSCI)是一种无创、无标记的实时全视野血流图，是一种很有前途的术中脑血流监测工具。我们的目标是展示LSCI在神经血管手术过程中连续可视化血流的能力。LSCI硬件安装在手术显微镜上，不干扰显微镜的正常运行。为了更方便地实时可视化脑血流，LSCI图像与内置显微镜白光相机配准，使LSCI图像叠加在白光图像上，并实时连续显示给神经外科医生。当显微镜放置在患者上方时，在整个手术过程中都会进行LSCI，为外科医生提供了动脉瘤夹闭或动静脉畸形(AVM)切除前、中、后血流变化的实时可视化。LSCI还与吲哚青绿血管造影术(ICGA)进行比较，以评估动脉瘤夹闭和AVM手术期间的CBF；LSCI硬件与显微镜的集成使LSCI和ICGA能够同时采集。结果表明，LSCI可以提供连续和实时的CBF可视化，而不影响外科医生的工作流程，也不需要造影剂。结果还表明，LSCI和ICGA提供了关于血管灌注的不同但互补的信息。
Laser speckle contrast imaging (LSCI) has emerged as a promising tool for intraoperative cerebral blood flow (CBF) monitoring because it produces real-time full-field blood flow maps noninvasively and label free. We aim to demonstrate the ability of LSCI to continuously visualize blood flow during neurovascular procedures. LSCI hardware was attached to the surgical microscope and did not interfere with the normal operation of the microscope. To more easily visualize CBF in real time, LSCI images were registered with the built-in microscope white light camera such that LSCI images were overlaid on the white light images and displayed to the neurosurgeon continuously in real time. LSCI was performed throughout each surgery when the microscope was positioned over the patient, providing the surgeon with real-time visualization of blood flow changes before, during, and after aneurysm clipping or arteriovenous malformation (AVM) resection in humans. LSCI was also compared with indocyanine green angiography (ICGA) to assess CBF during aneurysm clipping and AVM surgery; integration of the LSCI hardware with the microscope enabled simultaneous acquisition of LSCI and ICGA. The results suggest that LSCI can provide continuous and real-time CBF visualization without affecting the surgeon workflow or requiring a contrast agent. The results also demonstrate that LSCI and ICGA provide different, yet complementary information about vessel perfusion.