Grambow Eberhard, Sandkühler Niels Arne, Groß Justus, Thiem Daniel G E, Dau Michael, Leuchter Matthias, Weinrich Malte
Department of General, Visceral, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, 18057 Rostock, Germany.
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany.
J Clin Med. 2022 Jan 30;11(3):758. doi: 10.3390/jcm11030758.
Assessment of tissue oxygenation is an important aspect of detection and monitoring of patients with peripheral artery disease (PAD). Hyperspectral imaging (HSI) is a non-contact technology for assessing microcirculatory function by quantifying tissue oxygen saturation (StO). This study investigated whether HSI can be used to monitor skin oxygenation in patients with PAD after appropriate treatment of the lower extremities.
For this purpose, 37 patients with PAD were studied by means of ankle-brachial index (ABI) and HSI before and after surgical or endovascular therapy. Thereby, the oxygenation parameter StO and near infrared (NIR) perfusion index were quantified in seven angiosomes on the diseased lower leg and foot. In addition, the effects of skin temperature and physical activity on StO and the NIR perfusion index and the respective inter-operator variability of these parameters were investigated in 25 healthy volunteers.
In all patients, the ABI significantly increased after surgical and endovascular therapy. In parallel, HSI revealed significant changes in both StO and NIR perfusion index in almost all studied angiosomes depending on the performed treatment. The increase in tissue oxygenation saturation was especially pronounced after surgical treatment. Neither heat nor cold, nor physical activity, nor repeated assessments of HSI parameters by independent investigators significantly affected the results on StO and the NIR perfusion index.
Tissue oxygen saturation data obtained with HSI are robust to external confounders, such as temperature and physical activity, and do not show inter-operator variability; therefore, can be used as an additional technique to established methods, such as the ABI, to monitor peripheral perfusion in patients with PAD.
组织氧合评估是外周动脉疾病（PAD）患者检测和监测的重要方面。高光谱成像（HSI）是一种通过量化组织氧饱和度（StO）来评估微循环功能的非接触技术。本研究调查了HSI是否可用于监测下肢经适当治疗后的PAD患者的皮肤氧合情况。
为此，对37例PAD患者在手术或血管内治疗前后通过踝臂指数（ABI）和HSI进行研究。从而在患病小腿和足部的七个血管区域量化氧合参数StO和近红外（NIR）灌注指数。此外，在25名健康志愿者中研究了皮肤温度和身体活动对StO和NIR灌注指数的影响以及这些参数各自的操作者间变异性。
在所有患者中，手术和血管内治疗后ABI显著增加。同时，HSI显示几乎所有研究的血管区域中，根据所进行的治疗，StO和NIR灌注指数均有显著变化。手术治疗后组织氧合饱和度的增加尤为明显。热、冷、身体活动以及独立研究者对HSI参数的重复评估均未显著影响StO和NIR灌注指数的结果。
通过HSI获得的组织氧饱和度数据不受温度和身体活动等外部混杂因素的影响，且不显示操作者间变异性；因此，可作为一种附加技术，与如ABI等既定方法一起用于监测PAD患者的外周灌注情况。
