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使用激光散斑对比成像监测肝脏缺血再灌注期间的微血管血流变化。

The monitoring of microvascular liver blood flow changes during ischemia and reperfusion using laser speckle contrast imaging.

作者信息

Li Chong Hui, Wang Hong Dong, Hu Jian Jun, Ge Xin Lan, Pan Ke, Zhang Ai Qun, Dong Jia Hong

机构信息

Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical College, Beijing, China; Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical College, Beijing, China.

Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical College, Beijing, China; Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical College, Beijing, China.

出版信息

Microvasc Res. 2014 Jul;94:28-35. doi: 10.1016/j.mvr.2014.04.010. Epub 2014 May 2.

Abstract

OBJECTIVE

The recovery of microvascular liver blood flow (LBF) after ischemia is an important determinant of the degree of hepatocellular injury. Laser speckle contrast imaging (LSCI) was recently suggested to be a suitable instrument for monitoring the LBF. This study was designed to evaluate LSCI in monitoring the LBF changes during liver ischemia and reperfusion (IR).

METHODS

A rat model with 120-min ischemia and 60-min reperfusion to 90% of the liver (entire liver except the caudate lobe, which was kept as portal blood bypass) was used. The LBF of the sham operation (SO) group and the IR group was measured with LSCI at the following time points: before ischemia (Baseline), 5 min after the start of ischemia (I-5 min), 5 min before the end of ischemia (I-115 min) and 5 and 60 min after the start of reperfusion (R-5 min and R-60 min). The reproducibility among different rats or repeated measurements, the liver histopathology, the liver biological zero (BZ) and the influence of liver movement on the LSCI measurements were investigated.

RESULTS

The entire exposed liver surface after laparotomy was suitable for full-view LSCI imaging. Establishing many circular or oval regions of interest (ROIs) on the LSCI flux image was a simple and convenient method for calculating and comparing the LBF of different ROIs and different liver lobes. There was good-to-moderate intra-individual and inter-individual reproducibility for the LSCI measurements of the LBF in the rats of the SO group. In the IR group, the total blood inflow occlusion resulted in a notable drop of the LBF from the baseline (P<0.05) that remained for the 120 min of ischemia. The LBF decreased further after the reperfusion (P<0.05), reflecting the IR-induced liver microcirculation dysfunction. The histopathological examination revealed severe hepatic sinus congestion and damaged hepatocytes in the IR group. The no flow BZ and liver movement contributed to the LBF values.

CONCLUSIONS

LSCI technology is a simple, convenient and accurate method for the real-time monitoring of microvascular LBF changes during ischemia and reperfusion, regardless of the contribution of biological zero and liver movement. This finding suggests the possible application of LSCI for monitoring the microvascular LBF changes intraoperatively.

摘要

目的

缺血后肝微血管血流(LBF)的恢复是肝细胞损伤程度的重要决定因素。最近有人提出激光散斑对比成像(LSCI)是监测LBF的合适工具。本研究旨在评估LSCI在监测肝脏缺血再灌注(IR)期间LBF变化中的作用。

方法

采用大鼠模型,对90%的肝脏进行120分钟缺血和60分钟再灌注(整个肝脏除尾状叶外,尾状叶作为门静脉血旁路)。在以下时间点用LSCI测量假手术(SO)组和IR组的LBF:缺血前(基线)、缺血开始后5分钟(I-5分钟)、缺血结束前5分钟(I-115分钟)以及再灌注开始后5分钟和60分钟(R-5分钟和R-60分钟)。研究了不同大鼠之间或重复测量的可重复性、肝脏组织病理学、肝脏生物零值(BZ)以及肝脏运动对LSCI测量的影响。

结果

剖腹术后整个暴露的肝脏表面适合进行全视野LSCI成像。在LSCI通量图像上建立多个圆形或椭圆形感兴趣区域(ROI)是计算和比较不同ROI和不同肝叶LBF的简单便捷方法。SO组大鼠LBF的LSCI测量在个体内和个体间具有良好到中等的可重复性。在IR组中,总血流阻断导致LBF从基线显著下降(P<0.05),在120分钟缺血期间一直保持。再灌注后LBF进一步下降(P<0.05),反映了IR诱导的肝脏微循环功能障碍。组织病理学检查显示IR组肝窦严重充血和肝细胞受损。无血流BZ和肝脏运动对LBF值有影响。

结论

LSCI技术是一种简单、便捷且准确的方法,可实时监测缺血再灌注期间微血管LBF的变化,无论生物零值和肝脏运动的影响如何。这一发现提示LSCI可能用于术中监测微血管LBF的变化。

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