Detection of calcified atherosclerotic plaque by laser-induced plasma emission.
Detection of calcified atherosclerotic plaque by laser-induced plasma emission.
复制标题
通过激光诱导等离子体发射检测钙化动脉粥样硬化斑块。
DOI：
10.1002/lsm.1900120106
复制
发表时间：
1992
影响因子：
2.4
通讯作者：
Baker,G
中科院分区：
文献类型：
--
作者：
Deckelbaum,LI;Scott,JJ;Stetz,ML;O'Brien,KM;Baker,G
使用荧光光谱法区分动脉粥样硬化和正常组织受到钙化动脉粥样硬化斑块的灵敏度低于非钙化动脉粥样硬化斑块的限制（分别为65%和93%）。为了评价等离子体发射作为检测钙化斑块的方法，使用脉冲钬激光（λ = 2.1 μm，能量密度=4 J/mm 2）通过血液中的100 μm石英光纤照射325例正常和动脉粥样硬化尸体主动脉部位。位于光纤近端附近的光电二极管在激光脉冲期间检测等离子体发射。在0%（0/110）的正常、0%（0/107）的非钙化动脉粥样硬化组织和91%（98/108）的钙化动脉粥样硬化部位检测到血浆发射。光谱分析证实了钙化动脉粥样硬化斑块的血浆发射中存在钙线。虽然产生等离子体需要烧蚀能量密度（> 3 J/mm 2），但单个激光脉冲在正常组织中仅烧蚀67 ± 16 μm的深度。在另外10个钙化动脉粥样硬化部位，只要检测到等离子体发射，就继续进行激光消融。在所有病例中，斑块消融在动脉穿孔前终止。此外，血浆检测的连续使用提高了正常和动脉粥样硬化组织的荧光光谱分类的准确性。总之，血浆检测对钙化动脉粥样硬化斑块具有高灵敏度（91%）和特异性（100%），并且可能是激光血管成形术引导的有用辅助手段。此外，等离子体检测可以既简单又便宜地实现。
The use of fluorescence spectroscopy to discriminate atherosclerotic from normal tissue is limited by a lower sensitivity for calcified than noncalcified atherosclerotic plaque (65% vs. 93%, respectively). To evaluate plasma emission as a means to detect calcified plaque, 325 normal and atherosclerotic cadaveric aortic sites were irradiated through a 100‐μm silica fiber in blood by a pulsed holmium laser (λ = 2.1 μm, fluence =4 J/mm2). A photo‐diode positioned near the proximal end of the fiber detected plasma emission during a laser pulse. Plasma emission was detected at 0% (0/110) of normal, 0% (0/107) of noncalcified atherosclerotic tissue, and 91% (98/108) of calcified atherosclerotic sites. Spectroscopic analysis confirmed the presence of calcium lines in the plasma emission from calcified atherosclerotic plaque. Although ablative fluences (> 3 J/mm2) were required for plasma generation, a single laser pulse ablated only to a depth of 67 ± 16 μm in normal tissue. In an additional 10 calcified atherosclerotic sites, laser ablation was continued as long as plasma emission was detected. In all cases, plaque ablation was terminated before arterial perforation. Furthermore, the adjunctive use of plasma detection improved the accuracy of fluorescence spectroscopic classification of normal and atherosclerotic tissue. In conclusion, plasma detection has a high sensitivity (91%) and specificity (100%) for calcified atherosclerotic plaque and may be a useful adjunct for laser angioplasty guidance. Furthermore, plasma detection can be implemented both simply and inexpensively.