Optical coherence tomography: a reliable alternative to invasive histological assessment of acute wound healing in human skin?
Optical coherence tomography: a reliable alternative to invasive histological assessment of acute wound healing in human skin?
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DOI：
10.1111/bjd.12786
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发表时间：
2014-04-01
影响因子：
10.3
通讯作者：
Bayat, A.
中科院分区：
文献类型：
--
作者：
Greaves, N. S.;Benatar, B.;Bayat, A.
传统上，通过活检组织的组织学分析来评估急性伤口愈合的金标准。然而，这个过程是侵入性的，具有公认的副作用。光学相干断层扫描（OCT）是一种非侵入性的技术，产生高分辨率的实时图像的皮肤architecture. ObjectiveTo比较OCT与组织学评估在体内急性伤口愈合，并确定之间的协议定义的皮肤structures.Methods的测量模式的水平打孔活检（5毫米）从50名健康志愿者收获。伤口通过二期愈合，直到根据随机分组在7、14、21或28天后再次切除。每周使用OCT对伤口进行评估，持续6周，并与时间匹配活检的组织学结果进行比较。四个皮肤结构的尺寸测量使用两种方式和协议的水平建立了Bland-Altman分析。上层网状真皮的平均灰度值（MGV）来自OCT图像在所有的时间point.Results两种技术显示在正常和受伤的皮肤与相关的结构变化与炎症，增生和重塑伤口愈合阶段的解剖一致性。MGV在创伤后6周显著增加（P = 0.001），并且可能代表伤口纤维化的新测量。尽管组织形态测量值与低，但一致的偏差（范围-4.181至0.431 μ m）良好的关联，Bland-Altman图显示OCT和histologic.Conclusions之间的协议较差，光学相干断层扫描能够准确评估愈合组织活检标本的组织学分析可比。这种非侵入性工具非常适合伤口评估，并可能代表打孔活检的诊断替代方案。
Background Gold-standard assessment of acute wound healing has traditionally been through histological analysis of biopsied tissue. However, this process is invasive with recognized side-effects. Optical coherence tomography (OCT) is a noninvasive technique generating high-resolution real-time images of cutaneous architecture.Objectives To compare OCT with histological assessment of in vivo acute wound healing and ascertain the level of agreement between modalities for measurement of defined cutaneous structures.Methods Punch biopsies (5 mm) were harvested from 50 healthy volunteers. Wounds healed by secondary intention until they were re-excised 7, 14, 21 or 28 days later depending on random group allocation. Wounds were assessed weekly for 6 weeks using OCT and compared with histological findings derived from time-matched biopsies. Dimensions of four cutaneous structures were measured using both modalities and the level of agreement was established by Bland-Altman analysis. The mean greyscale value (MGV) of the upper reticular dermis was derived from OCT images at all time points.Results Both techniques showed anatomical congruity in normal and wounded skin with correlating architectural changes associated with inflammatory, proliferative and remodelling wound healing phases. MGV was significantly increased 6 weeks after wounding (P = 0.001) and may represent a novel measure of wound fibrosis. Despite good association of histomorphometric values with low but consistent bias (range -4.181 to 0.431 mu m), Bland- Altman plots demonstrated poor agreement between OCT and histology.Conclusions Optical coherence tomography enabled accurate assessment of healing tissue comparable with histological analysis of biopsy specimens. This noninvasive tool is highly suited to wound assessment and may represent a diagnostic alternative to punch biopsies.