Vonnahme F J
Scan Electron Microsc. 1984(Pt 1):173-82.
Diagnostic scanning electron microscopic (SEM) investigations can be performed in human liver biopsies after perfusion fixation. For needle and wedge biopsies transparenchymal perfusion techniques have been developed. The perfusion fluid is brought into the tissue through special cannulas and removed by suction. By means of this 'push and pull' method, a directional flow is achieved and the tissue specimens are cleaned of blood. Thus the inner surfaces of the parenchymal tissue are accessible and can be observed with SEM. Vascular changes in different liver diseases, such as sinusoidal stenosis or sinusoidal capillarization, are easily detectable. New aspects are obtained on the morphology, arrangement and the functional role of perisinusoidal cells during mesenchymal reaction. This gives new insights into the pathophysiology of the microcirculation. SEM is also of great significance in diagnosing liver tumours. It may aid in deciding the origin and differentiation of carcinomas or sarcomas. Moreover, for the first time the sinusoidal haemangioendothelioma , consisting of fenestrated sinusoidal cells, could be demonstrated with SEM. Cholestasis can be diagnosed with SEM. However, we were unable to obtain useful information with SEM for the differential diagnosis of intra- and extrahepatic cholestasis.
诊断性扫描电子显微镜（SEM）检查可在灌注固定后的人体肝活检组织中进行。针对针吸活检和楔形活检，已经开发出了经实质灌注技术。灌注液通过特殊插管进入组织，并通过抽吸排出。借助这种“推挽”方法，可实现定向流动，从而清除组织标本中的血液。这样，实质组织的内表面就可以被观察到，并且能用扫描电子显微镜进行观察。不同肝脏疾病中的血管变化，如窦性狭窄或窦性毛细血管化，很容易被检测到。在间充质反应过程中，关于窦周细胞的形态、排列及其功能作用有了新的认识。这为微循环的病理生理学提供了新的见解。扫描电子显微镜在肝肿瘤的诊断中也具有重要意义。它可能有助于确定癌或肉瘤的起源和分化。此外，首次通过扫描电子显微镜证实了由有窗孔的窦状细胞组成的窦性血管内皮瘤。扫描电子显微镜可用于诊断胆汁淤积。然而，我们无法通过扫描电子显微镜获得用于肝内和肝外胆汁淤积鉴别诊断的有用信息。
