Langhout Gerrit C, Bydlon Torre M, van der Voort Marjolein, Müller Manfred, Kortsmit Jeroen, Lucassen Gerald, Balthasar Andrea J R, van Geffen Geert-Jan, Steinfeldt Thorsten, Sterenborg Henricus J C M, Hendriks Benno H W, Ruers Theo J M
Department of Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Philips Research, In-Body Systems Department, HTC 34, 5656 AE Eindhoven, The Netherlands.
Lasers Surg Med. 2018 Mar;50(3):253-261. doi: 10.1002/lsm.22755. Epub 2017 Nov 21.
Identification of peripheral nerve tissue is crucial in both surgery and regional anesthesia. Recently, optical tissue identification methods are presented to facilitate nerve identification in transcutaneous procedures and surgery. Optimization and validation of such techniques require large datasets. The use of alternative models to human in vivo, like human post mortem, or swine may be suitable to test, optimize and validate new optical techniques. However, differences in tissue characteristics and thus optical properties, like oxygen saturation and tissue perfusion are to be expected. This requires a structured comparison between the models.
Comparative observational study.
Nerve and surrounding tissues in human (in vivo and post mortem) and swine (in vivo and post mortem) were structurally compared macroscopically, histologically, and spectroscopically. Diffuse reflective spectra were acquired (400-1,600 nm) after illumination with a broad band halogen light. An analytical model was used to quantify optical parameters including concentrations of optical absorbers.
Several differences were found histologically and in the optical parameters. Histologically nerve and adipose tissue (subcutaneous fat and sliding fat) showed clear similarities between human and swine while human muscle enclosed more adipocytes and endomysial collagen. Optical parameters revealed model dependent differences in concentrations of β-carotene, water, fat, and oxygen saturation. The similarity between optical parameters is, however, sufficient to yield a strong positive correlation after cross model classification.
This study shows and discusses similarities and differences in nerve and surrounding tissues between human in vivo and post mortem, and swine in vivo and post mortem; this could support the discussion to use an alternative model to optimize and validate optical techniques for clinical nerve identification. Lasers Surg. Med. 50:253-261, 2018. © 2017 Wiley Periodicals, Inc.
在外科手术和区域麻醉中,识别周围神经组织都至关重要。近来,人们提出了光学组织识别方法,以促进经皮手术和外科手术中的神经识别。此类技术的优化和验证需要大量数据集。使用人体死后或猪等人体活体的替代模型,可能适合测试、优化和验证新的光学技术。然而,可以预期组织特征以及诸如氧饱和度和组织灌注等光学特性会存在差异。这就需要对这些模型进行结构化比较。
比较观察性研究。
对人体(活体和死后)以及猪(活体和死后)的神经及周围组织进行宏观、组织学和光谱学结构比较。用宽带卤素灯照明后获取漫反射光谱(400 - 1600纳米)。使用分析模型量化包括光吸收剂浓度在内的光学参数。
在组织学和光学参数方面发现了若干差异。组织学上,神经和脂肪组织(皮下脂肪和滑动脂肪)在人和猪之间显示出明显相似性,而人体肌肉包含更多脂肪细胞和肌内膜胶原蛋白。光学参数揭示了β - 胡萝卜素、水、脂肪和氧饱和度浓度在模型之间存在差异。然而,光学参数之间的相似性足以在跨模型分类后产生强正相关。
本研究展示并讨论了人体活体和死后以及猪活体和死后神经及周围组织的异同;这有助于支持关于使用替代模型来优化和验证用于临床神经识别的光学技术的讨论。《激光外科与医学》50:253 - 261, 2018。© 2017威利期刊公司