Basile Giuseppe, Breda Alberto, Gomez Rivas Juan, Cacciamani Giovanni, Okhunov Zhamshid, Dourado Aurus, Rodriguez Socarras Moises, Sgrò Edoardo, Cozzupoli Pietro, Veneziano Domenico
Department of Urology and Kidney Transplantation, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy -
Department of Urology and Kidney Transplantation, Puigvert Foundation, Barcelona, Spain.
Minerva Urol Nefrol. 2019 Jun;71(3):280-285. doi: 10.23736/S0393-2249.19.03353-8. Epub 2019 Mar 18.
Infrared thermography (IRT) imaging technology is able to measure surface temperatures in real-time. The aim of our study is to understand whether IRT imaging is a reliable technology for the assessment of kidney-parenchyma perfusion with warm fluids.
We used three porcine kidneys as a sample. IRT was compared to Near-infrared fluorescence (NIRF) technology with Indocyanine Green (ICG), X-rays with Contrast medium was used as a benchmark. Each kidney, placed inside an incubator, was perfused with contrast medium by a vascular 6-Fr catheter, to preview the perfusable parenchymal area. 100 mL of saline solution at 45 °C was then administered along a five-minutes time, followed by a second administration of 2/10 diluted ICG solution. A FLIR© C2 IR camera was used to acquire thermal data. During ICG administration, image acquisition was obtained with FireFly technology, with a 0° endoscopic camera. Quantitative variables are described using median and quartiles.
Real-time evaluation by IRT showed that, after five minutes of perfusion, it was possible to highlight the same parenchymal areas as visualized by X-ray. The IR images showed that surface temperature rise was directly reflecting local perfusion with heated saline solution. Analysis of NIRF technology and ICG showed an overlap between the two technologies. In addition to the compared technology, IR provided separate temperature measurement for each pixel in real time. Our findings were replicable on all the three kidneys examined. Higher resolution IR-cameras could provide even more detailed information.
Although NIRF technology with ICG is providing more image detail, we demonstrated that IRT is capable of detecting kidney parenchyma perfusion with warm fluids. Further studies will show its feasibility in graft re-perfusion assessment during kidney transplant or similar applications.
红外热成像（IRT）技术能够实时测量表面温度。我们研究的目的是了解IRT成像是否是一种用于评估肾脏实质用温热液体灌注情况的可靠技术。
我们使用三个猪肾作为样本。将IRT与使用吲哚菁绿（ICG）的近红外荧光（NIRF）技术进行比较，使用含造影剂的X射线作为基准。每个置于培养箱内的肾脏通过一根6F血管导管灌注造影剂，以预览可灌注的实质区域。然后在五分钟内注入100 mL 45℃的生理盐水，随后第二次注入2/10稀释的ICG溶液。使用FLIR© C2红外相机获取热数据。在注入ICG期间，使用FireFly技术和0°内窥镜相机进行图像采集。定量变量用中位数和四分位数描述。
IRT的实时评估表明，灌注五分钟后，可以突出显示与X射线所见相同的实质区域。红外图像显示表面温度升高直接反映了温热盐水溶液的局部灌注情况。对NIRF技术和ICG的分析表明这两种技术之间存在重叠。除了所比较的技术外，红外还能实时为每个像素提供单独的温度测量。我们的发现在所检查的所有三个肾脏上均可重复。更高分辨率的红外相机可以提供更详细的信息。
虽然使用ICG的NIRF技术提供了更多的图像细节，但我们证明了IRT能够检测肾脏实质用温热液体的灌注情况。进一步的研究将表明其在肾移植或类似应用中移植物再灌注评估中的可行性。
