Optical Coherence Tomography for Microsurgical Guidance

神经和小血管修复是重要的、广泛应用的医疗技术。目前的技术不允许在组织表面以下进行成像，因此不能建立束或血管层的对准。神经错位是目前神经修复效果不佳的主要原因之一。同样，对于小血管修复，无法从表面检测到的内膜瓣和外膜反转可导致亚急性血管闭塞。光学相干层析成像(OCT)是近年来发展起来的一种高分辨率成像技术。OCT类似于超声波，测量的是后向反射的红外光的强度，而不是声音。OCT的分辨率在2-20微米之间，比临床上可用的任何仪器都高出25倍。除了高分辨率，OCT的优势还包括高数据采集速率、紧凑的便携尺寸、小而便宜的探头，以及能够与各种形式的光谱相结合。这项工作的假设是OCT可以用于改善神经和小血管修复的结果。这一假设将通过以下具体目标进行验证：1.开发临床上可行的手持式探头，2.开发全数字多普勒系统，3.研究体外血管修复的结构和多普勒OCT，4.研究体内血管修复的结构和多普勒OCT，5.在体内进行OCT和传统外科显微镜的比较研究，6.使用结构、偏振和光谱数据来识别传感器和运动神经，以及7.在OCT引导下指导神经外膜修复。

Nerve and small vessel repair are important, widely used medical techniques. Current technologies do not allow imaging to be performed below the tissue surface, so that the alignment of fascicles or vessel layers can not be established. Misalignment is one of the major reasons that the results of nerve repair are currently poor. Similarly, with small vessel repair, intimal flap and adventitial inversions, which can not be detected from the surface, can lead to subacute vascular occlusion. Optical coherence tomography (OCT) is a recently developed high resolution imaging modality. OCT is analogous to ultrasound, measuring the intensity of backreflected infrared light rather than sound. The resolution of OCT is between 2-20 mum, up to 25X higher than anything available in clinical medicine. In addition to it's high resolution, advantages of OCT include its high data acquisition rate, compact portable size, the small inexpensive probes, and the ability to be combine with various forms of spectroscopy. The hypothesis of this work is that OCT can be used to improve the outcome of nerve and small vessel repair. The hypothesis will be tested with the following specific aims: 1. Develop a clinically viable hand held probe, 2. Development of an all digital Doppler system, 3. Investigate structural and Doppler OCT for vascular repair in vitro, 4. Investigate structural and Doppler OCT for vascular repair in vivo, 5. Perform studies comparing OCT and Conventional surgical microscopy in vivo, 6. Use structural, polarization, and spectroscopic data to identify sensor vs motor nerves, and 7. guide epineural nerve repair with OCT guidance.