Direct in vivo visualization of human renal microcirculation using less-invasive intravital videomicroscopy. -vascular structure and renal blood flow-

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Several technical approaches for the evaluation of renal microcirculation have been developed Although each methodology possesses unique advantages, their common disadvantage is in the need for substantial manipulation on the kidney that might alter the renal microvascular responsiveness.To circumvent this drawback of previous approaches to renal microcirculation, we have developed a pencil-lens probe ($ 1mm, length : 25cm, weight 160g) with the charge-coupled divice (CCD) intravital videomicroscopic system (spatial resolution : 0.86um, time resolution : 30 frame/sec), which combines the characteristics ofmicroscopy and endoscopy. This system allowed us to perform less- invasive evaluation of both the renal structure and microcirculation approach to laparoscopic hole and open operation. Furthermore, real-time imaging of afferent and efferent arterioles, as well as glomeruli can be continuously assessed, thus permitting the functional characterization of microcirculation. A line segment was set along the glomerular capillaries and then a spatiotemporal image was constructed along the segment. The angle of stripped pattern in the spatiotempolar image, which is related to the erythrocyte velocity, was applied to compute erythrocyte velocity vectors as previously reported from Ogasawara et al group. Motion analysis of sequential images yields data on velocity of erythrocytes and leukocytes in glomeruli. In conclusion, this less-invasive technique will reveal as yet unknown field of renal microcirculation.