Transserosal optical coherence tomography (OCT) with angiography modality (OCTA) provides real-time label-free visualization of the intestinal structure and blood vessels networks with a spatial resolution about 10-15 µm. This method is a perspective for intraoperative use in abdominal surgery, for example, for determining the depth of ischemic damage to the gut. The paper devoted to analysis the quality of OCT/OCTA data obtained from small intestine of 4 subjects - rat, rabbit, minipigs and humans. The subjects have different thickness of intestinal wall and blood circulation conditions. It was shown, that the intestine of small laboratory animals (rats and rabbits) is convenient for studying with OCT/OCTA: it can be easily stabilized by moving the intestine loop outside the body, which, together with a rigidly fixed probe, minimizes the number of possible motion artifacts. Therefore, OCT/OCTA criteria of structural changes in the intestinal wall and microcirculation disorders during ischemia, important for clinical applications, were established on these objects. Large animals (minipigs) and human proved to be a troublesome subjects for obtaining high-quality OCT/OCTA data: powerful peristaltic movements, pronounced pulse wave and the inability to take the object out of the body in order to exclude the influence of respiratory and other types of the body movements led to a sharp increase in the amount of OCT/OCTA images with artifacts (up to 39% in humans). However, in patients and minipigs the microstructure of intestinal layers was more informative than in small animals due to increased thickness. Therefore, it allowed visualize tissues in more detail: in particular, verify peritoneum edema and intramuscular fluid buildup. The study was performed under support of RFBR grant No.19-75-10096.
A method, based on optical coherence angiography (OCA), for the intraoperative diagnosis of blood microcirculation in the ischemic intestine has been tested. The pilot clinical study involved 18 patients who had undergone urgent operations for thrombosis of segments II or III of the superior mesenteric artery, as well as for infringement of the bowel and the mesenteric vessels. In the OCA images regions of preserved blood microcirculation in the intestinal wall were characterized by the presence of branched networks of intramural microvessels and a bright background in the OCA images. Regions of the intestine in which the intramural vessels were interrupted or could not be visualized were considered as potentially non-viable. These data were used to determine the boundaries for intestinal resection. In comparison with the traditional method of intraoperative diagnosis of intestinal blood flow, the use of such OCA criteria meant the volume of bowel resection could be decreased by 21.5 [14.1; 36.0]% (p = 0.037). This observation demonstrates the great potential of OСA in the intraoperative detection of the boundaries of damaged and healthy intestinal wall in ischemic bowel disease.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.