Laser Doppler perfusion imaging of skin blood flow using red and near-infrared sources.

At present, scanning laser Doppler imaging uses a 633-nm helium-neon laser (RED) as the only light source, but this restricts its ability to measure blood flow (i) at darkly pigmented skin and (ii) from deeper or subdermal structures. Because near-infrared (NIR) light is known to penetrate deeper into tissue and to be less absorbed than RED, two imagers were adapted to include a NIR laser diode source (one of 830 nm for UK studies; one of 780 nm for leprosy field trials) in parallel with the existing RED source. In human hands representing a range of skin pigmentations, RED scans were unobtainable at the darkest areas of skin, but intact NIR scans could be collected in all cases. In experiments at the rat knee and the dorsal human hand, NIR and RED values were similar on normal skin. Over underlying vessels, however, NIR values greatly exceeded RED values, an effect abolished by occlusion. Similarly, in patients with leprosy and in healthy controls in Spain, fingerpulp NIR values exceeded RED values to the greatest degree when thermoregulatory flow was highest, i.e., when the deeper-lying arteriovenous anastomoses were open. Over areas of experimental inflammation, NIR gave higher values and also exhibited a greater degree of spatial heterogeneity than RED. We conclude that some current limitations of laser Doppler imaging technology can be overcome by the use of NIR laser diode sources.