Nerve autofluorescence in near-ultraviolet light markedly enhances nerve visualization in vivo
Nerve autofluorescence in near-ultraviolet light markedly enhances nerve visualization in vivo
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DOI：
10.1007/s00464-021-08484-0
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发表时间：
2021-04-09
影响因子：
3.1
通讯作者：
Rosenthal, Raul J.
中科院分区：
文献类型：
--
作者：
Dip, Fernando;Bregoli, Pedro;Rosenthal, Raul J.
在手术中，外科医生必须准确定位神经，避免损伤神经。最近，我们发现神经在近紫外光（NUV）下发出荧光。当前研究的目的是确定在NUV光下神经荧光比背景和血管结构更亮的程度，并确定神经与其他组织最容易区分的NUV强度。方法选取5只250 ~ 300 gm Wistar大鼠，在20%、35%、50%、100%的NUV强度下，暴露大腿后段坐骨神经。荧光光谱测量荧光亮度，使用Image-J软件量化荧光评分，并通过unpaired Student's t检验对神经、背景、动脉和静脉进行统计学比较，并进行Bonferroni调整以适应多重比较。计算每个NUV强度的敏感性、特异性和准确性。结果在20、35、50和100% NUV强度下，神经与背景组织的荧光评分分别为117.4比40.0,225.8比88.0,250.6比121.4,252.8比169.4（均p < 0.001）。神经的荧光评分在NUV强度为50%时趋于稳定，但背景的荧光评分继续上升。在35%，50%和100% NUV强度下，荧光评分为200是100%的敏感性，特异性和准确识别神经。在100 NUV强度下，动脉和静脉评分分别为61.8和60.0，均显著低于神经评分（p < 0.001）。结论在所有NUV强度>= 35%时，荧光评分为200是100%准确区分神经与体内其他解剖结构。
Background During surgery, surgeons must accurately localize nerves to avoid injuring them. Recently, we have discovered that nerves fluoresce in near-ultraviolet light (NUV) light. The aims of the current study were to determine the extent to which nerves fluoresce more brightly than background and vascular structures in NUV light, and identify the NUV intensity at which nerves are most distinguishable from other tissues. Methods We exposed sciatic nerves within the posterior thigh in five 250-300 gm Wistar rats, then observed them at four different NUV intensity levels: 20%, 35%, 50%, and 100%. Brightness of fluorescence was measured by fluorescence spectroscopy, quantified as a fluorescence score using Image-J software, and statistically compared between nerves, background, and both an artery and vein by unpaired Student's t tests with Bonferroni adjustment to accommodate multiple comparisons. Sensitivity, specificity, and accuracy were calculated for each NUV intensity. Results At 20, 35, 50, and 100% NUV intensity, fluorescence scores for nerves versus background tissues were 117.4 versus 40.0, 225.8 versus 88.0, 250.6 versus 121.4, and 252.8 versus 169.4, respectively (all p < 0.001). Fluorescence scores plateaued at 50% NUV intensity for nerves, but continued to rise for background. At 35%, 50%, and 100% NUV intensity, a fluorescence score of 200 was 100% sensitive, specific, and accurate identifying nerves. At 100 NUV intensity, artery and vein scores were 61.8 and 60.0, both dramatically lower than for nerves (p < 0.001). Conclusions At all NUV intensities >= 35%, a fluorescence score of 200 is 100% accurate distinguishing nerves from other anatomical structures in vivo.