LASER-INDUCED FLUORESCENCE PLAQUE DETECTION IN PATIENTS

之前，我们已经证明了荧光光谱学可以 在尸检中可靠地区分动脉粥样硬化和正常部位 标本。为了确定体内导管的可行性 基于荧光检测的系统，可用于 临床激光血管成形术，25名患者被研究在 在手术室或在心导管实验室使用 325 nm氦镉连续激光激发源和 光学多道荧光分析。既有激励也有 荧光光通过一种普通的柔性光纤传输 往返于远端冠状动脉和主动脉部位的纤维束 被标记为正常或异常基于直接 观察或血管镜检。可分析光谱(n=124)为 从92%的站点获得，并需要冲洗纤维组织 联系。正常位置的单态荧光光谱 在不同患者之间表现出显著的峰位差异 子组。正常部位的这种患者间和患者内的变异性 高峰期比我们之前在我们的 实验室。先进的算法可以区分正常的站点 在大多数情况下来自异常部位(p小于0.005)，但 体内异常部位识别的敏感性(67%)较低 而不是体外数据。我们从这项初步研究中得出结论 通过光纤的荧光可以安全可靠地记录下来 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， 与体外标本相比，敏感性有所降低。 然而，我们认为普通光纤的技术 荧光光谱学作为目标识别的一种手段 结合在基于双激光计算机的组织系统中 消融。

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.