LASER-INDUCED FLUORESCENCE PLAQUE DETECTION IN PATIENTS

患者体内的激光诱导荧光斑块检测

• 批准号: 3942964
• 负责人: M B LEON
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3942964
• 关键词: arteriosclerosis; cardiovascular imaging /visualization; clinical biomedical equipment; endoscopy; fiber optics; fluorescence spectrometry; human subject

Previously, we have shown that fluorescence spectroscopy can reliably differentiate atheroma from normal sites in necropsy specimens. To determine the feasibility of an in vivo catheter based fluorescence detection system which can be used for clinical laser angioplasty, 25 patients were studied either in the operating room or in the cardiac catheterization laboratory using a 325nm helium cadmium continuous laser excitation source and optical multichannel fluorescence analysis. Both excitation and fluorescence light was transmitted via a common flexible optical fiber bundle to and from remote coronary and aortic sites which were labelled either normal or abnormal based on direct observation or angioscopy. Analyzable spectra (n=124) were obtained from 92% of all sites and required flush fiber-tissue contact. Monomorphic fluorescence spectra from normal sites showed significant variations in peak position among patient subgroups. This inter and intrapatient variability of normal site peaks was for greater than previous necropsy data obtained in our laboratories. Advanced algorithms could distinguish normal sites from abnormal sites in most cases (p less than .005) but the sensitivity of in vivo abnormal site recognition (67%) was less than in vitro data. We conclude from this preliminary study that fluorescence via optical fibers can be recorded safely and reliably in patients. In vivo tissue optics and other factors may result in higher inter and intrapatient variability of normal site peaks. Fluorescence detection of atheroma in patients, although possible, is somewhat less sensitive when compared to in vitro specimens. However, we believe that the technique of common fiber fluorescence spectroscopy as a means of target recognition can be incorporated within a dual laser computer based system for tissue ablation.

以前，我们已经表明，荧光光谱可以 在尸检中可靠地区分动脉粥样硬化与正常部位 标本 确定体内导管的可行性 基于荧光检测系统，其可用于 临床激光血管成形术，25例患者进行了研究，无论是在 手术室或心导管实验室使用 325nm氦镉连续激光激发源， 光学多通道荧光分析 激发和 荧光通过一个普通的柔性光学元件 纤维束往返于远端冠状动脉和主动脉部位， 被标记为正常或异常， 观察或血管镜检查。 可分析光谱（n=124） 从92%的所有部位获得，需要冲洗纤维组织 contact. 来自正常位点的单态荧光光谱 显示患者之间的峰值位置存在显著差异 分组。 正常部位的这种患者间和患者内变异性 峰值大于我们之前获得的尸检数据 laboratories. 先进的算法可以区分正常的网站 在大多数情况下（p <0.005）， 体内异常部位识别的敏感性（67 而不是体外数据。 我们从初步研究中得出结论， 可以安全可靠地记录通过光纤的荧光 在病人身上。 体内组织光学和其他因素可能导致 正常部位峰值的患者间和患者内变异性较高。 荧光检测患者的动脉粥样硬化，虽然可能， 与体外样本相比，其灵敏度稍低。 然而，我们相信普通纤维的技术 荧光光谱作为目标识别的手段， 结合在用于组织的基于双激光计算机的系统内 消融术