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Subcutaneous Lymphatic Vessels in the Lower Extremities: Comparison between Photoacoustic Lymphangiography and Near-Infrared Fluorescence Lymphangiography.

下肢皮下淋巴管: 光声淋巴管造影与近红外荧光淋巴管造影的比较。

  • 影响因子:5.83
  • DOI:10.1148/radiol.2020191710
  • 作者列表:"Suzuki Y","Kajita H","Konishi N","Oh A","Urano M","Watanabe S","Asao Y","Imanishi N","Tsuji T","Jinzaki M","Aiso S","Kishi K
  • 发表时间:2020-05-01
Abstract

:Background Detailed visualization of the lymphatic vessels would greatly assist in the diagnosis and monitoring of lymphatic diseases and aid in preoperative planning of lymphedema surgery and postoperative evaluation. Purpose To evaluate the usefulness of photoacoustic imaging (PAI) for obtaining three-dimensional images of both lymphatic vessels and surrounding venules. Materials and Methods In this prospective study, the authors recruited healthy participants from March 2018 to January 2019 and imaged lymphatic vessels in the lower limbs. Indocyanine green (5.0 mg/mL) was injected into the subcutaneous tissue of the first and fourth web spaces of the toes and below the lateral malleolus. After confirmation of the lymphatic flow with near-infrared fluorescence (NIRF) imaging as the reference standard, PAI was performed over a field of view of 270 × 180 mm. Subsequently, the number of enhancing lymphatic vessels was counted in both proximal and distal areas of the calf and compared between PAI and NIRF. Results Images of the lower limbs were obtained with PAI and NIRF in 15 participants (three men, 12 women; average age, 42 years ± 12 [standard deviation]). All participants exhibited a linear pattern on NIRF images, which is generally considered a reflection of good lymphatic function. A greater number of lymphatic vessels were observed with PAI than with NIRF in both the distal (mean: 3.6 vessels ± 1.2 vs 2.0 vessels ± 1.1, respectively; P < .05) and proximal (mean: 6.5 vessels ± 2.6 vs 2.6 vessels ± 1.6; P < .05) regions of the calf. Conclusion Compared with near-infrared fluorescence imaging, photoacoustic imaging provided a detailed, three-dimensional representation of the lymphatic vessels and facilitated an increased understanding of their relationship with the surrounding venules. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Lillis and Krishnamurthy in this issue.

摘要

背景: 淋巴管的详细可视化将大大有助于淋巴疾病的诊断和监测,并有助于淋巴水肿手术的术前规划和术后评估。目的评价光声成像 (PAI) 在获取淋巴管和周围小静脉的三维图像中的有效性。材料和方法在这项前瞻性研究中,作者从2018年3月至2019年1月招募健康参与者,并对下肢的淋巴管进行成像。将吲哚菁绿 (5.0 mg/ml) 注射到脚趾的第一和第四网状间隙和外踝下方的皮下组织中。在用近红外荧光 (NIRF) 成像作为参考标准确认淋巴流动后,在270 × 180毫米的视野下进行PAI。随后,在小腿的近端和远端区域计数增强淋巴管的数量,并在PAI和NIRF之间进行比较。结果用PAI和NIRF获得了15名参与者的下肢图像 (3名男性,12名女性; 平均年龄,42岁 ± 12 [标准差])。所有参与者在NIRF图像上表现出线性模式,这通常被认为是良好淋巴功能的反映。在小腿的远端 (平均值: 3.6血管 ± 1.2 vs 2.0血管 ± 1.1,分别为P <.05) 和近端 (平均值: 6.5血管 ± 2.6 vs 2.6血管 ± 1.6; P < .05) 区域,PAI比NIRF观察到更多数量的淋巴管。结论与近红外荧光成像相比,光声成像提供了淋巴管的详细的三维表示,并有助于更好地了解它们与周围小静脉的关系。©RSNA,2020在线补充材料可用于本文。另见本期Lillis和Krishnamurthy的社论。

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影响因子:2.98
发表时间:2020-01-01
DOI:10.1136/neurintsurg-2019-014962
作者列表:["Guo W","Liu H","Tan Z","Zhang X","Gao J","Zhang L","Guo H","Bai H","Cui W","Liu X","Wu X","Luo J","Qu Y"]

METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.

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