Hyperspectral imaging for label-free in vivo identification of myocardial scars and sites of radiofrequency ablation lesions.
Hyperspectral imaging for label-free in vivo identification of myocardial scars and sites of radiofrequency ablation lesions.
复制标题
高光谱成像用于无标记体内识别心肌疤痕和射频消融病变部位。
DOI：
10.1016/j.hrthm.2017.12.014
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发表时间：
2018
期刊：
影响因子：
5.5
通讯作者：
Sarvazyan,NarineA
中科院分区：
文献类型：
--
作者：
Swift,LutherM;Asfour,Huda;Muselimyan,Narine;Larson,Cinnamon;Armstrong,Kenneth;Sarvazyan,NarineA
背景心律失常的治疗通常涉及消融疤痕心肌岛内或附近的存活肌肉组织。目的探索一种高光谱成像(HSI)方法来描述和区分射频消融所致的瘢痕组织和组织损伤。方法射频消融大鼠开胸手术后，对活体大鼠的脑室表面进行射频消融，动物恢复期为2个月。在第二次手术中，新的射频损伤被放置在前一次消融过程中留下的疤痕组织旁边。结果从射频损伤部位、瘢痕区域及周围未消融组织获得的激发-发射矩阵显示多种光谱变化。这些发现证明了使用365纳米紫外光照明心脏表面的HSI是合理的，同时获得了可见范围内的光谱图像。基于自体荧光的HSI能够区分开胸大鼠射频损伤的部位与瘢痕或未消融的心肌。结论基于组织自体荧光变化的高频超声心动图是一种在活体内显示心肌瘢痕表面边界的有效工具，具有较高的空间分辨率，可与射频消融术引起的急性坏死区相鉴别。
BackgroundTreatment of cardiac arrhythmias often involves ablating viable muscle tissue within or near islands of scarred myocardium. Yet, today there are limited means by which the boundaries of such scars can be visualized during surgery and distinguished from the sites of acute injury caused by radiofrequency (RF) ablation.ObjectiveWe sought to explore a hyperspectral imaging (HSI) methodology to delineate and distinguish scar tissue from tissue injury caused by RF ablation.MethodsRF ablation of the ventricular surface of live rats that underwent thoracotomy was followed by a 2-month animal recovery period. During a second surgery, new RF lesions were placed next to the scarred tissue from the previous ablation procedure. The myocardial infarction model was used as an alternative way to create scar tissue.ResultsExcitation-emission matrices acquired from the sites of RF lesions, scar region, and the surrounding unablated tissue revealed multiple spectral changes. These findings justified HSI of the heart surface using illumination with 365 nm UV light while acquiring spectral images within the visible range. Autofluorescence-based HSI enabled to distinguish sites of RF lesions from scar or unablated myocardium in open-chest rats. A pilot version of a percutaneous HSI catheter was used to demonstrate the feasibility of RF lesion visualization in atrial tissue of live pigs.ConclusionHSI based on changes in tissue autofluorescence is a highly effective tool for revealing—in vivo and with high spatial resolution—surface boundaries of myocardial scar and discriminating it from areas of acute necrosis caused by RF ablation.