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Non-invasive terahertz imaging of tissue water content for flap viability assessment

机译:组织含水量的非侵入性太赫兹成像用于皮瓣可行性评估

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摘要

Accurate and early prediction of tissue viability is the most significant determinant of tissue flap survival in reconstructive surgery. Perturbation in tissue water content (TWC) is a generic component of the tissue response to such surgeries, and, therefore, may be an important diagnostic target for assessing the extent of flap viability in vivo. We have previously shown that reflective terahertz (THz) imaging, a non-ionizing technique, can generate spatially resolved maps of TWC in superficial soft tissues, such as cornea and wounds, on the order of minutes. Herein, we report the first in vivo pilot study to investigate the utility of reflective THz TWC imaging for early assessment of skin flap viability. We obtained longitudinal visible and reflective THz imagery comparing 3 bipedicled flaps (i.e. survival model) and 3 fully excised flaps (i.e. failure model) in the dorsal skin of rats over a postoperative period of 7 days. While visual differences between both models manifested 48 hr after surgery, statistically significant (p < 0.05, independent t-test) local differences in TWC contrast were evident in THz flap image sets as early as 24 hr. Excised flaps, histologically confirmed as necrotic, demonstrated a significant, yet localized, reduction in TWC in the flap region compared to non-traumatized skin. In contrast, bipedicled flaps, histologically verified as viable, displayed mostly uniform, unperturbed TWC across the flap tissue. These results indicate the practical potential of THz TWC sensing to accurately predict flap failure 24 hours earlier than clinical examination.
机译:组织活力的准确和早期预测是重建手术中组织瓣存活的最重要决定因素。组织含水量(TWC)的扰动是组织对此类手术反应的一般组成部分,因此可能是评估体内皮瓣活力程度的重要诊断目标。先前我们已经表明,反射式太赫兹(THz)成像是一种非电离技术,可以在数分钟左右的时间内在浅表软组织(例如角膜和伤口)中生成TWC的空间分辨图。在此,我们报告了第一个体内前期研究,目的是研究反射THz TWC成像在早期评估皮瓣活力方面的实用性。我们获得了纵向可见和反射THz图像,在术后7天的时间段内比较了大鼠背部皮肤中的3个双蒂皮瓣(即生存模型)和3个完全切除的皮瓣(即衰竭模型)。尽管两种模型之间的视觉差异在术后48小时出现,但THz皮瓣图像组早在24小时时就具有统计学上显着的统计学差异(p <0.05,独立t检验)。经组织学检查证实为坏死的皮瓣与非骨伤性皮肤相比,皮瓣区域的TWC明显降低,但局部发生了减少。相反,经组织学证实为可行的双蒂皮瓣在皮瓣组织中显示出几乎均匀,不受干扰的TWC。这些结果表明,太赫兹TWC感应比临床检查提前24小时准确预测皮瓣衰竭的实际潜力。

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