Meissner Oliver A, Schmedt Claus-Georg, Hunger Kathrin, Hetterich Holger, Sroka Ronald, Rieber Johannes, Babaryka Gregor, Steckmeier Bernd Manfred, Reiser Maximilian, Siebert Uwe, Mueller-Lisse Ullrich
Institute for Clinical Radiology, Ludwig Maximilians University, Ziemssenstr. 1, 80336 Munich, Germany.
Eur Radiol. 2007 Sep;17(9):2384-93. doi: 10.1007/s00330-007-0593-2. Epub 2007 Feb 8.
Endovascular optical coherence tomography (OCT) is a new imaging modality providing histology-like information of the venous wall. Radiofrequency ablation (RFA) and laser therapy (ELT) are accepted alternatives to surgery. This study evaluated OCT for qualitative assessment of venous wall anatomy and tissue alterations after RFA and ELT in bovine venous specimens. One hundred and thirty-four venous segments were obtained from ten ex-vivo bovine hind limbs. OCT signal characteristics for different wall layers were assessed in 180/216 (83%) quadrants from 54 normal venous cross-sections. Kappa statistics (kappa) were used to calculate intra- and inter-observer agreement. Qualitative changes after RFA (VNUS-Closure) and ELT (diode laser 980 nm, energy densities 15 Joules (J)/cm, 25 J/cm, 35 J/cm) were described in 80 venous cross-sections. Normal veins were characterized by a three-layered appearance. After RFA, loss of three-layered appearance and wall thickening at OCT corresponded with circular destruction of tissue structures at histology. Wall defects after ELT ranged from non-transmural punctiform damage to complete perforation, depending on the energy density applied. Intra- and inter-observer agreement for reading OCT images was very high (0.90 and 0.88, respectively). OCT allows for reproducible evaluation of normal venous wall and alterations after endovenous therapy. OCT could prove to be valuable for optimizing endovenous therapy in vivo.
血管内光学相干断层扫描（OCT）是一种新的成像方式，可提供静脉壁类似组织学的信息。射频消融（RFA）和激光治疗（ELT）是被认可的手术替代方法。本研究评估了OCT对牛静脉标本在RFA和ELT后静脉壁解剖结构和组织改变的定性评估。从10个离体牛后肢获取了134个静脉段。在54个正常静脉横切面的180/216（83%）象限中评估了不同壁层的OCT信号特征。使用Kappa统计量（kappa）计算观察者内和观察者间的一致性。在80个静脉横切面上描述了RFA（VNUS闭合）和ELT（980 nm二极管激光，能量密度15焦耳（J）/厘米、25 J/厘米、35 J/厘米）后的定性变化。正常静脉的特征是呈现三层结构。RFA后，OCT上三层结构的丧失和壁增厚与组织学上组织结构的环形破坏相对应。ELT后的壁缺损范围从不穿壁的点状损伤到完全穿孔，这取决于所施加的能量密度。观察者内和观察者间读取OCT图像的一致性非常高（分别为0.90和0.88）。OCT能够对正常静脉壁和腔内治疗后的改变进行可重复评估。OCT可能被证明对优化体内腔内治疗有价值。
