Waibel Jill S, Rudnick Ashley C, Wulkan Adam J, Holmes Jon D
J Drugs Dermatol. 2016 Nov 1;15(11):1375-1380.
In recent decades, a number of optimal diagnostic technologies have emerged to assist in tissue visualization. Real-time monitoring of skin during laser therapies will help optimize laser parameters for more ef cient therapies. One of these technologies, optimal coherence tomography (OCT), may be used to help visualize burn and traumatic scars. When lasing severe scars, lasers have tunable pulse energies, which are made proportional to the scar thickness as estimated by palpation and the physician eye. This has historically been estimated by the clinician with no objective data. OCT is an emerging non-invasive imaging technique that provides a cross-sectional image of tissue micro-architecture from a depth of 0.7 - 1.5 mm. The signal intensity is related to the tissue optical scattering properties, which in turn is related to tissue constituents such as collagen density. Thus, OCT may provide an objective non-invasive measurement of scar depth.
Thirty burn and traumatic scars were imaged with quality, traceable, and veri able OCT data from burn and trauma patients both pre- and post- laser therapy. OCT was rapid and ef cient (approximately 2 minutes) to scan skin to visualize real-time scar tissue in different areas of heterogenous scars. The OCT image of the scar was compared to that of normal tissue in order to identify scar tissue and estimate its depth. Laser parameters were then dialed to treat full thickness of the scar.
Clinical and OCT correlation between atrophic versus hypertrophic scars was found. However, in most cases the clinicians underestimated the depth of the scar in the dermis.
The treatment of burn and traumatic scars for both civilian and wounded warriors can be challenging. As these scars are often very deep, OCT allows for non-invasive examination of the thickness of the scar allowing the physician better accuracy for laser settings in the treatment for the full thickness of the scar tissue. J Drugs Dermatol. 2016;15(11):1375-1380..
近几十年来，出现了许多优化的诊断技术来辅助组织可视化。激光治疗期间对皮肤进行实时监测将有助于优化激光参数，以实现更有效的治疗。其中一种技术，即光学相干断层扫描（OCT），可用于辅助烧伤和创伤性瘢痕的可视化。在对严重瘢痕进行激光治疗时，激光具有可调脉冲能量，其与通过触诊和医生肉眼估计的瘢痕厚度成比例。历史上，这一直由临床医生进行估计，并无客观数据。OCT是一种新兴的非侵入性成像技术，可提供深度为0.7 - 1.5毫米的组织微观结构的横截面图像。信号强度与组织的光学散射特性相关，而光学散射特性又与诸如胶原蛋白密度等组织成分相关。因此，OCT可提供瘢痕深度的客观非侵入性测量。
对30例烧伤和创伤性瘢痕患者在激光治疗前后进行了高质量、可追溯且可验证的OCT数据成像。OCT扫描皮肤快速且高效（约2分钟），可实时可视化不同区域异质性瘢痕中的瘢痕组织。将瘢痕的OCT图像与正常组织的图像进行比较，以识别瘢痕组织并估计其深度。然后调整激光参数以治疗瘢痕的全层。
发现萎缩性瘢痕与增生性瘢痕之间存在临床和OCT相关性。然而，在大多数情况下，临床医生低估了真皮层瘢痕的深度。
治疗平民和受伤战士的烧伤和创伤性瘢痕可能具有挑战性。由于这些瘢痕通常很深，OCT可对瘢痕厚度进行非侵入性检查，使医生在治疗瘢痕组织全层时能更准确地设置激光参数。《皮肤药物学杂志》2016年；15(
