Fernie J M, Lamb D
J Clin Pathol. 1985 Dec;38(12):1380-7. doi: 10.1136/jcp.38.12.1380.
Using a digitiser for assessing the media and intima of muscular pulmonary arteries, we have previously shown that the most sensible measurements are those of medial and intimal area and that artery size should be defined in terms of the total length of internal elastic lamina. These measurements do not vary with the collapse or constriction of the artery. A cross sectional cut and a well defined internal elastic lamina are essential for measurement using our technique. This study explores methods for obtaining the above three measurements for cross sectionally cut arteries with an ill defined internal elastic lamina, with a view to increasing the number of arteries measured. The methods were tested on three subjects, using arteries for which the true values of the three variables were known. Acceptable estimates of medial and intimal area could be obtained by simply delineating the boundaries of the intima and media and ignoring the crinkles in the elastic laminae. It was also found that muscular pulmonary arteries may not be uniformly collapsed or constricted round the circumference of their walls and that the overall degree of collapse or constriction seemed to be affected by the size of the artery. An acceptable estimate of the total length of an internal elastic lamina was most readily obtained by multiplying the length of the boundary between intima and media by a crinkle factor based on an optical assessment of the amount of crinkling in that internal elastic lamina.
我们之前使用数字化仪评估肌性肺动脉的中膜和内膜,结果表明,最合理的测量指标是中膜和内膜面积,且动脉大小应以弹性内皮层的总长度来界定。这些测量值不会因动脉的塌陷或收缩而改变。使用我们的技术进行测量时,横断面切片和清晰的弹性内皮层至关重要。本研究探索了对弹性内皮层不清晰的横断面动脉获取上述三项测量值的方法,旨在增加可测量动脉的数量。这些方法在三名受试者身上进行了测试,所使用的动脉其三个变量的真实值是已知的。通过简单勾勒内膜和中膜的边界并忽略弹性层中的褶皱,即可获得中膜和内膜面积的可接受估计值。研究还发现,肌性肺动脉壁圆周上的塌陷或收缩可能并不均匀,且塌陷或收缩的总体程度似乎受动脉大小的影响。通过将内膜与中膜之间边界的长度乘以基于对该弹性内皮层褶皱程度的光学评估得出的褶皱因子,最容易获得弹性内皮层总长度的可接受估计值。