Popp Alexander, Wendel Martina, Knels Lilla, Koch Thea, Koch Edmund
Medical Faculty of Technical University Dresden, Clinical Sensoring and Monitoring, Fetscherstrasse 74, 01307 Dresden, Germany.
J Biomed Opt. 2006 Jan-Feb;11(1):014015. doi: 10.1117/1.2162158.
In this feasibility study, Fourier domain optical coherence tomography (FDOCT) is used for visualizing the 3-D structure of fixated lung parenchyma and to capture real-time cross sectional images of the subpleural alveolar mechanics in a ventilated and perfused isolated rabbit lung. The compact and modular setup of the FDOCT system allows us to image the first 500 microm of subpleural lung parenchyma with a 3-D resolution of 16 x 16 x 8 microm (in air). During mechanical ventilation, real-time cross sectional FDOCT images visualize the inflation and deflation of alveoli and alveolar sacks (acini) in successive images of end-inspiratory and end-expiratory phase. The FDOCT imaging shows the relation of local alveolar mechanics to the setting of tidal volume (VT), peak airway pressure, and positive end-expiratory pressure (PEEP). Application of PEEP leads to persistent recruitment of alveoli and acini in the end-expiratory phase, compared to ventilation without PEEP where alveolar collapse and reinflation are observed. The imaging of alveolar mechanics by FDOCT will help to determine the amount of mechanical stress put on the alveolar walls during tidal ventilation, which is a key factor in understanding the development of ventilator induced lung injury (VILI).
在这项可行性研究中，傅里叶域光学相干断层扫描（FDOCT）用于可视化固定肺实质的三维结构，并在通气和灌注的离体兔肺中获取胸膜下肺泡力学的实时横截面图像。FDOCT系统紧凑且模块化的设置使我们能够以16×16×8微米（在空气中）的三维分辨率对胸膜下肺实质的前500微米进行成像。在机械通气期间，实时横截面FDOCT图像在吸气末和呼气末相的连续图像中可视化肺泡和肺泡囊（腺泡）的膨胀和收缩。FDOCT成像显示了局部肺泡力学与潮气量（VT）、气道峰值压力和呼气末正压（PEEP）设置之间的关系。与未使用PEEP通气时观察到肺泡塌陷和再膨胀相比，应用PEEP会导致呼气末相肺泡和腺泡持续复张。通过FDOCT对肺泡力学进行成像将有助于确定潮气量通气期间肺泡壁上的机械应力大小，这是理解呼吸机诱导性肺损伤（VILI）发生发展的关键因素。
