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动脉瘤手术中激光散斑对比成像与微血管多普勒超声检查的前瞻性研究

Laser speckle contrast imaging versus microvascular Doppler sonography in aneurysm surgery: A prospective study.

作者信息

Dimanche Alexis, Goldberg Johannes, Miller David R, Bervini David, Raabe Andreas, Dunn Andrew K

机构信息

The University of Texas at Austin, Department of Biomedical Engineering, Austin, TX, United States.

Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

出版信息

World Neurosurg X. 2024 Apr 10;23:100377. doi: 10.1016/j.wnsx.2024.100377. eCollection 2024 Jul.

Abstract

OBJECTIVE

This study aimed to compare microvascular Doppler sonography (MDS) and laser speckle contrast imaging (LSCI) for assessing vessel patency and aneurysm occlusion during microsurgical clipping of intracranial aneurysms.

METHODS

MDS and LSCI were used after clip placement during six neurovascular procedures including six patients, and agreement between the two techniques was assessed. LSCI was performed in parallel or right after MDS evaluation. The Doppler response was assessed through listening while flow in the LSCI videos was evaluated by three blinded neurovascular surgeons after the surgery. Statistical analysis determined the agreement between the techniques in assessing flow in 18 regions of interest (ROIs).

RESULTS

Agreement between MDS and LSCI in assessing vessel patency was observed in 87 % of the ROIs. LSCI accurately identified flow in 93.3 % of assessable ROIs, with no false positive or negative measurements. Three ROIs were not assessable with LSCI due to motion artifacts or poor image quality. No complications were observed.

CONCLUSIONS

LSCI demonstrated high agreement with MDS in assessing vessel patency during microsurgical clipping of intracranial aneurysms. It provided continuous, real-time, full-field imaging with high spatial resolution and temporal resolution. While MDS allowed evaluation of deep vascular regions, LSCI complemented it by offering unlimited assessment of surrounding vessels.

摘要

目的

本研究旨在比较微血管多普勒超声(MDS)和激光散斑对比成像(LSCI)在颅内动脉瘤显微夹闭术中评估血管通畅情况和动脉瘤闭塞情况的效果。

方法

在包括6例患者的6例神经血管手术中,夹闭动脉瘤后使用MDS和LSCI,并评估这两种技术之间的一致性。LSCI在MDS评估之后并行进行或紧接着进行。通过听诊评估多普勒反应,术后由三名不知情的神经血管外科医生评估LSCI视频中的血流情况。统计分析确定了这两种技术在评估18个感兴趣区域(ROI)血流方面的一致性。

结果

在87%的ROI中观察到MDS和LSCI在评估血管通畅情况方面具有一致性。LSCI在93.3%的可评估ROI中准确识别出血流,没有假阳性或假阴性测量结果。由于运动伪影或图像质量差,有3个ROI无法用LSCI进行评估。未观察到并发症。

结论

在颅内动脉瘤显微夹闭术中评估血管通畅情况时,LSCI与MDS表现出高度一致性。它提供了具有高空间分辨率和时间分辨率的连续、实时、全场成像。虽然MDS可以评估深部血管区域,但LSCI通过对周围血管进行无限制评估对其进行了补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/11063637/eb058deaa5e2/gr1.jpg

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