Endosteal and periosteal blood flow quantified with dynamic contrast-enhanced fluorescence to guide open orthopaedic surgery.
Endosteal and periosteal blood flow quantified with dynamic contrast-enhanced fluorescence to guide open orthopaedic surgery.
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通过动态对比增强荧光定量骨内膜和骨膜血流量，以指导开放式骨科手术。
DOI：
10.1117/12.2546173
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Gitajn,ILeah
中科院分区：
文献类型：
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作者：
Jiang,Shudong;Elliott,JonathanT;Gunn,JasonR;Xu,Cao;Ruiz,AlbertoJ;Henderson,EricR;Pogue,BrianW;Gitajn,ILeah
由于缺乏客观可测量或可量化的方法来评估骨灌注，切除失活骨的成功率几乎完全取决于外科医生的经验，并且在外科医生和中心之间差异很大。在这项研究中，吲哚菁绿色（ICG）为基础的动态对比增强荧光成像（DCE-FI）已经开发出客观评估骨灌注和指导手术清创。通过商业荧光成像系统对猪创伤模型（n = 6只猪x 2条腿）进行成像，每个模型具有多达5种严重程度的血流损失。通过将骨特异性混合栓室（HyPC）动力学模型应用于4分钟视频序列，计算灌注相关指标，如峰值强度、总骨血流量（TBBF）和骨内膜骨血流量与TBBF分数（EFF）。结果表明，TBBF和EFF联合检测能有效区分损伤骨和正常骨，其准确性、敏感性和特异性分别为89%、88%和90%。我们随后的第一个非人骨血流成像研究证实，DCE-FI可以成功地转化为人类骨科创伤患者。
Due to the lack of objectively measurable or quantifiable methods to assess the bone perfusion, the success of removing devitalized bone is based almost entirely on surgeon’s experience and varies widely across surgeons and centers. In this study, an indocyanine green (ICG)-based dynamic contrast-enhanced fluorescence imaging (DCE-FI) has been developed to objectively assess bone perfusion and guide surgical debridement. A porcine trauma model (n = 6 pigs x 2 legs) with up to 5 conditions of severity in loss of flow in each, was imaged by a commercial fluorescence imaging system. By applying the bone-specific hybrid plug-compartment (HyPC) kinetic model to four-minute video sequences, the perfusion-related metrics, such as peak intensity, total bone blood flow (TBBF) and endosteal bone blood flow to TBBF fraction (EFF) were calculated. The results shown that the combination of TBBF and EFF can effectively differentiate injured from normal bone with the accuracy, sensitivity and specificity of 89%, 88% and 90%, respectively. Our subsequent first inhuman bone blood flow imaging study confirmed DCE-FI can be successfully translated into human orthopaedic trauma patients.