Observations of the bowel wall in the case of acute ischemia: optical coherence tomography, FLIM macro-imaging and histological analysis data

Kiseleva, Elena B.; Ryabkov, M. G.; Bederina, Evgeniya; Shirmanova, Marina V.; Baleev, Mikhail S.; Lukina, Maria M.; Sirotkina, Marina A.; Chilipenok, Aleksandra S.; Бесчастнов, В. В.; Moiseev, Alexander A.; Zagaynova, Elena V.; Gladkova, Natalia D.

doi:10.1117/12.2550667

Cited by 3 publications

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“…Our experience of experimental and clinical research has shown that the data obtained on the AMI model in laboratory animals could only partially be extrapolated to clinical diagnosis in patients. OCTA of the small intestine of patients has shown both similarities and differences from the data obtained in experiment on laboratory animals (rats, miniature pigs) [ 49 , 59 ]. Apparently, the differences in the OCTA picture of the small intestine (both in the norm and in ischemia) between laboratory animals and humans are due to the anatomical and physiological parameters of the vascular system of the small intestine, namely, the thickness and optical density of the serous membrane, the depth of the location of large vessels, their diameter and the blood flow rate.…”

Section: Discussionmentioning

confidence: 99%

“…An OCT picture of ischemic damage to the wall of the small intestine in humans with AMI has not been previously obtained or assessed. We set out to test whether multimodal (MM) OCT, which has proven its effectiveness in studies of AMI models in laboratory animals [ 49 , 59 ], is effective here. This would enable us to obtain objective data on the state of the human intestinal wall with AMI in a clinical situation.…”

Section: Introductionmentioning

confidence: 99%

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Prospects of Intraoperative Multimodal OCT Application in Patients with Acute Mesenteric Ischemia

et al. 2021

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Introduction: Despite the introduction of increasingly multifaceted diagnostic techniques and the general advances in emergency abdominal and vascular surgery, the outcome of treatment of patients with acute impaired intestinal circulation remains unsatisfactory. The non-invasive and high-resolution technique of optical coherence tomography (OCT) can be used intraoperatively to assess intestine viability and associated conditions that frequently emerge under conditions of impaired blood circulation. This study aims to demonstrate the effectiveness of multimodal (MM) OCT for intraoperative diagnostics of both the microstructure (cross—polarization OCT mode) and microcirculation (OCT angiography mode) of the small intestine wall in patients with acute mesenteric ischemia (AMI). Methods and Participants: A total of 18 patients were enrolled in the study. Nine of them suffered from AMI in segments II-III of the superior mesenteric artery (AMI group), whereby the ischemic segments of the intestine were examined. Nine others were operated on for adenocarcinoma of the colon (control group), thus allowing areas of their normal small intestine to be examined for comparison. Data on the microstructure and microcirculation in the walls of the small intestine were obtained intraoperatively from the side of the serous membrane using the MM OCT system (IAP RAS, Russia) before bowel resection. The MM OCT data were compared with the results of histological examination. Results: The study finds that MM OCT visualized the damage to serosa, muscularis externa, and blood vessels localized in these layers in 100% of AMI cases. It also visualized the submucosa in 33.3% of AMI cases. The MM OCT images of non-ischemic (control group), viable ischemic, and necrotic small intestines (AMI group) differed significantly across stratification of the distinguishable layers, the severity of intermuscular fluid accumulations, and the type and density of the vasculature. Conclusion: The MM OCT diagnostic procedure optimally meets the requirements of emergency surgery. Data on the microstructure and microcirculation of the intestinal wall can be obtained simultaneously in real time without requiring contrast agent injections. The depth of visualization of the intestinal wall from the side of the serous membrane is sufficient to assess the volume of the affected tissues. However, the methodology for obtaining MM OCT data needs to be improved to minimize the motion artefacts generated in actual clinical conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prospects of Intraoperative Multimodal OCT Application in Patients with Acute Mesenteric Ischemia

et al. 2021

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“…Изображения ММ ОКТ неишемической, ишемической, жизнеспособной и некротической тонкой кишки значительно различаются по объему накопления экстравазальной жидкости, структуре мышечных пучков в продольном мышечном слое, типу и плотности сосудистой системы. ММ ОКТ доказала свою эффективность в исследованиях моделей ОМИ на лабораторных животных [53,54]. Kiseleva E. и соавт.…”

Section: оптическая когерентная томография (окт)unclassified

Modern methods of assessing the viability of the intestinal wall (review)

Valiev,

Hasanov,

Galimova

et al. 2023

Koloproktologiâ

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AIM: to highlight modern methods of assessing the viability of the intestinal wall.MATERIALS AND METHODS: the search was made using electronic databases. We explored multiple sources, including, but not limited to, monographs, journal articles, books and websites.RESULTS: despite recent advances in scientific methods and technologies, currently the visual method remains the most popular for assessing the viability of the intestinal wall, which includes parameters such as color of the intestinal wall, peristalsis, and arterial pulsation.CONCLUSION: it would be fair to conclude that such methods as hyperspectral imaging, multimodal coherent tomography provide greater flexibility and details on the intestinal viability. However, further research is needed to determine their value in clinical practice. To the date, the most studied and applied method is fluorescent angiography, which allows to assess the viability of the intestine for most of its length.

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“…Small laboratory animals (rats) are an excellent (suitable) objects for AMI modelling [11,12] and intramural perfusion and structural tissue changes monitoring using OCT/OCTA [13,14]. The main advantages of the experimental small animal studies are high reproducibility of the pathology modelling, full-thickness (up to the lumen) visualization of the intestine, and high quality (artefact-free) of the obtained OCT/OCTA images.…”

Section: Introductionmentioning

confidence: 99%

“…However, contrary to the microcirculation which can be easily attributed to a particular morphological layer due to the unequivocal features of the vessels in each layer, some of the individual intestine layers are not well differentiable from each other. One can only approximately distinguish the joint serosa + muscularis externa layers and submucosa + mucosa layers, which creates certain difficulties in interpreting the presence of necrosis in a particular layer during AMI surgery [13,14]. It is known that the ischemic damage in the intestine wall layers develops at different rates and the foci of necrosis in the mucosa may not be accompanied by the visible changes in the serous membrane [15].…”

Section: Introductionmentioning

confidence: 99%

Attenuation coefficient for layer-by-layer assessment of the intestinal wall in acute ischemia according to optical coherence tomography

Kiseleva¹,

Ryabkov²,

Moiseev³

et al. 2022

Laser Phys. Lett.

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Small laboratory animals (rats) are suitable objects for modelling acute mesenteric ischemia (AMI) and monitoring changes in the structural tissue and intramural blood flow using optical coherence tomography (OCT) and OCT angiography methods. Combined with evaluation of blood circulation the prevalence of a necrotic tissue is a key factor in assessing intestine viability during surgery and determining the resection margins. While the assessment of the blood vessels network is commonly performed visually by surgeons, the assessment of the necrosis within individual layers is quite challenging due to small thickness of each intestine layer in small objects. The study demonstrates that the construction of colour-coded maps of the tissue attenuation coefficient estimated from the OCT data, allows quick layer-by-layer evaluation of the intestine wall. Such maps in the AMI model make it possible to track changes separately in the serous-muscular, submucosa and mucosa layers of the intestine wall in vivo and to carry out a differential diagnosis between the inflammation and necrosis in these layers. Colour-coded mapping may be useful in other medical applications where layer-by-layer assessment of structural tissue changes is required in a small range of depths.

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Observations of the bowel wall in the case of acute ischemia: optical coherence tomography, FLIM macro-imaging and histological analysis data

Cited by 3 publications

References 0 publications

Prospects of Intraoperative Multimodal OCT Application in Patients with Acute Mesenteric Ischemia

Prospects of Intraoperative Multimodal OCT Application in Patients with Acute Mesenteric Ischemia

Modern methods of assessing the viability of the intestinal wall (review)

Attenuation coefficient for layer-by-layer assessment of the intestinal wall in acute ischemia according to optical coherence tomography

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