In vivo optical coherence tomography of the human larynx: Normative and benign pathology in 82 patients
In vivo optical coherence tomography of the human larynx: Normative and benign pathology in 82 patients
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DOI：
10.1097/01.mlg.0000181465.17744.be
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发表时间：
2005-11-01
期刊：
影响因子：
2.6
通讯作者：
Chen, ZP
中科院分区：
文献类型：
--
作者：
Wong, BJF;Jackson, RP;Chen, ZP
目标。光学相干断层扫描 (OCT) 是一种新兴的成像方式，它将低相干光与干涉测量相结合，产生分辨率约为 10 μm 的组织横截面图像。使用光纤 OCT 成像探头对接受外科头颈内窥镜检查的患者进行检查，以研究和表征喉部的微观结构解剖结构和特征以及体内良性喉部病理学。研究设计。前瞻性临床试验。材料和方法。 115 名因各种头颈部病变接受外科内窥镜检查的患者中，有 82 名患者进行了喉部 OCT 成像。 OCT 设备采用 1.3 μm 宽带光源（FWHM，80 nm）。帧速率为 1 Hz。使用与目标部位紧密接触的手持式探头进行成像。所成像感兴趣区域的最大轴向和横向尺寸为 2.5 mm x 6 mm，分辨率为 10 pm。同时，获得常规内窥镜图像以提供与 OCT 图像和组织学的解剖相关性。进行光学测微法来测量上皮厚度。结果。喉部结构和亚部位的系统 OCT 成像提供了信息。上皮的厚度、基底膜的完整性和固有层的结构。确定的微观结构特征包括腺体、导管、血管、积液/水肿以及假复层柱状上皮和复层鳞状上皮之间的过渡。计算喉部亚位点的平均上皮厚度：真声带（129μm）、假声带（124μm）、杓会厌襞（177μm）、声门下（98μm）和会厌（185μm）。真实的声带病理影像包括赖因克水肿、乳头状瘤病、息肉、粘液囊肿和肉芽组织。声门下成像确定了上皮、固有层和软骨之间的边界。 OCT 图像与传统组织病理学图像相比具有优势。结论：OCT 具有独特的喉部组织微观结构成像能力，可以详细描述良性、癌前和恶性喉部病理的显微解剖变化。 OCT 具有指导手术活检、直接治疗和监测疾病的潜力，特别是在开发基于办公室的系统时。这是研究喉部的一种有前途的成像方式。
Objectives. Optical coherence tomography (OCT) is an emerging imaging modality that combines low-coherence light with interferometry to produce cross-sectional images of tissue with resolution about 10 mu m. Patients undergoing surgical head and neck en doscopy were examined using a fiberoptic OCT imaging probe to study and characterize microstructural anatomy and features of the larynx and benign laryngeal pathology in vivo. Study Design. Prospective clinical trial. Materials and Methods. OCT imaging of the larynx was performed in 82 of 115 patients who underwent surgical endoscopy for various head and neck pathologies. The OCT device employs a 1.3 mu m broadband light source (FWHM, 80 nm). The frame rate is 1 Hz. Imaging was performed using a handheld probe placed in near contact with the target site. The maximum axial and lateral dimensions for the region of interest imaged were 2.5 mm x 6 mm, with resolutions of 10 pm. Simultaneously, conventional endoscopic images were obtained to provide anatomic correlation with OCT images and histology. Optical micrometry was performed to measure the epithelium thickness. Results. Systematic OCT imaging of laryngeal structures and subsites provided information. on the thickness of the epithelium, integrity of the basement membrane, and structure of the lamina propria. Microstructural features identified included glands, ducts, blood vessels, fluid collection/edema, and the transitions between pseudostratified columnar and stratified squamous epithelium. The mean epithelial thickness of laryngeal subsites was calculated: true vocal cord (129 mu m), false vocal cords (124 mu m), aryepiglottic fold (177 mu m), subglottis (98 mu m), and epiglottis (185 mu m). True vocal cord pathology imaged included Reinke's edema, papillomatosis, polyps, mucous cysts, and granulation tissue. Subglottic imaging identified boundaries between epithelium, lamina propria, and cartilage. The OCT images compared favorably with conventional histopathology. Conclusion: OCT has the unique ability to image laryngeal tissue microstructure and can detail microanatomic changes in benign, premalignant, and malignant laryngeal pathologies. OCT holds the potential to guide surgical biopsies, direct therapy, and monitor disease, particularly when office-based systems are developed. This is a promising imaging modality to study the larynx.