Lin Jinghui, Wu Yiwen, Deng Xinpeng, Zhou Shengjun, Liu Yuchun, Zhang Junjun, Zeng Yiyong, Li Xianru, Gao Xiang, Xu Bin, Zhou Chenhui
Department of Neurosurgery, Ningbo First Hospital, Ningbo University, Ningbo, Zhejiang, China.
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.
Front Neurol. 2023 Mar 30;14:1174072. doi: 10.3389/fneur.2023.1174072. eCollection 2023.
Cerebral revascularization surgery is the mainstay of treatment for moyamoya syndrome (MMS) today, and intraoperative determination of the patency of the revascularized vessel is a critical factor in the success of the procedure. Currently, major imaging modalities include intraoperative indocyanine green (ICG) videoangiography (ICG-VA), digital subtraction angiography (DSA), and vascular ultrasound Doppler. Infrared thermography is a modern imaging modality with non-contact devices for the acquisition and analysis of thermal data. We aimed to investigate the feasibility and advantages of infrared thermography in determining anastomotic patency during MMS surgery.
Indocyanine green videoangiography and infrared thermography were performed simultaneously in 21 patients with MMS who underwent bypass surgery. The detection result of vessel patency was compared, and the feasibility and advantages of infrared thermography were assessed.
The patency of the anastomosis was accurately determined in 21 patients using either ICG angiography or infrared thermography. In 20 patients, the results of infrared thermography showed that the vascular anastomosis was unobstructed, and there was an agreement with the subsequent results of ICG-VA. In one patient, we suspected inadequate patency after testing the anastomosis with infrared thermography, and the results of ICG-VA evaluation of the anastomosis confirmed that there was indeed an anastomotic obstruction.
Compared with ICG-VA, infrared thermography might offer an alternative non-invasive, contrast-free option in assessing anastomosis patency compared with ICG-VA, and it is likely to become more widely used in the clinic in the near future.
脑血运重建手术是当今烟雾病综合征（MMS）治疗的主要手段，术中确定血运重建血管的通畅性是手术成功的关键因素。目前，主要的成像方式包括术中吲哚菁绿（ICG）血管造影（ICG-VA）、数字减影血管造影（DSA）和血管超声多普勒。红外热成像技术是一种利用非接触设备采集和分析热数据的现代成像方式。我们旨在研究红外热成像技术在MMS手术中确定吻合口通畅性的可行性和优势。
对21例行搭桥手术的MMS患者同时进行吲哚菁绿血管造影和红外热成像检查。比较血管通畅性的检测结果，评估红外热成像技术的可行性和优势。
使用ICG血管造影或红外热成像技术均准确确定了21例患者吻合口的通畅性。在20例患者中，红外热成像结果显示血管吻合通畅，与随后的ICG-VA结果一致。在1例患者中，用红外热成像技术检测吻合口后，我们怀疑通畅性不足，ICG-VA对吻合口的评估结果证实确实存在吻合口梗阻。
与ICG-VA相比，红外热成像技术在评估吻合口通畅性方面可能提供一种非侵入性、无需造影剂的替代选择，并且在不久的将来可能会在临床上得到更广泛的应用。
