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Abstract：
OBJECTIVE: A current therapeutic challenge of vascular lesions is that they do not always respond effectively to laser treatment. Information on targeted vessels could potentially be used to guide laser treatments. Optical coherence tomography (OCT) is a useful tool for the non-invasive imaging of tissues, including skin hemangiomas and port wine birthmarks. Dynamic OCT is able to rapidly characterize cutaneous blood vessels. The primary goal of this study was to demonstrate the ability of bedside OCT to image (i) overall vessel pattern; (ii) individual vessel morphology, diameter and depth; and (iii) total vessel density as a function of depth in infantile hemangiomas and port wine birthmarks (PWB).
METHODS: This IRB approved, observational clinical trial was performed among healthy volunteers ages 3 months-73 years old. All patients presented for laser treatment of either infantile hemangiomas or PWB with skin types ranging from Fitzpatrick I-V. OCT imaging of 49 hemangioma and PWB scans were performed pre- and post-treatment. The diameter and depth of the blood vessels making up the vascular lesions were measured. In addition, normal skin was scanned for comparison. Five datasets for infantile hemangiomas and five for PWB that were without motion artifacts were analyzed.
RESULTS: Scanned lesions exhibited variable and highly heterogeneous blood vessel patterns with vessel diameters ranging from 20 to 160 μm, suggesting that the laser treatment with single pulse durations may not be optimal. The largest blood vessel diameter observed (160 μm) may not be adequately treated by commonly used pulsed dye laser pulse durations.
CONCLUSIONS: OCT allowed rapid, non-invasive characterization of the diameter and depth of blood vessels in individual vascular lesions. Imaged lesions consisted of a heterogeneous population of vessel sizes, morphologies, and depth. Future studies could utilize this information to assist development of individualized treatment protocols in an effort to improve vascular birthmark removal. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
METHODS: This IRB approved, observational clinical trial was performed among healthy volunteers ages 3 months-73 years old. All patients presented for laser treatment of either infantile hemangiomas or PWB with skin types ranging from Fitzpatrick I-V. OCT imaging of 49 hemangioma and PWB scans were performed pre- and post-treatment. The diameter and depth of the blood vessels making up the vascular lesions were measured. In addition, normal skin was scanned for comparison. Five datasets for infantile hemangiomas and five for PWB that were without motion artifacts were analyzed.
RESULTS: Scanned lesions exhibited variable and highly heterogeneous blood vessel patterns with vessel diameters ranging from 20 to 160 μm, suggesting that the laser treatment with single pulse durations may not be optimal. The largest blood vessel diameter observed (160 μm) may not be adequately treated by commonly used pulsed dye laser pulse durations.
CONCLUSIONS: OCT allowed rapid, non-invasive characterization of the diameter and depth of blood vessels in individual vascular lesions. Imaged lesions consisted of a heterogeneous population of vessel sizes, morphologies, and depth. Future studies could utilize this information to assist development of individualized treatment protocols in an effort to improve vascular birthmark removal. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
摘要：
目的：目前血管病变的治疗挑战是它们并不总是对激光治疗有效反应。有关目标血管的信息可能用于指导激光治疗。光学相干断层扫描（OCT）是一种有用的工具，用于组织的非侵入性成像，包括皮肤血管瘤和葡萄酒胎记。动态OCT能够快速表征皮肤血管。本研究的主要目的是证明床旁OCT成像的能力：（i）整体血管模式；（ii）个体血管形态，直径和深度；（iii）婴儿血管瘤和葡萄酒胎记（PWB）的总血管密度随深度的变化。
方法：本IRB批准，观察性临床试验在3个月至73岁的健康志愿者中进行.所有患者均接受了婴儿血管瘤或PWB的激光治疗，皮肤类型为FitzpatrickI-V。治疗前后进行49例血管瘤的OCT成像和PWB扫描。测量构成血管病变的血管的直径和深度。此外,扫描正常皮肤进行比较.分析了五个婴儿血管瘤的数据集和五个没有运动伪影的PWB的数据集。
结果：扫描的病变表现出可变和高度异质的血管模式，血管直径范围为20至160μm，这表明单脉冲持续时间的激光治疗可能不是最佳的。观察到的最大血管直径（160μm）可能无法通过常用的脉冲染料激光脉冲持续时间充分处理。
结论：OCT允许快速，在单个血管病变中血管直径和深度的非侵入性表征。成像病变由血管大小的异质性群体组成，形态学,和深度。未来的研究可以利用这些信息来帮助开发个性化的治疗方案，以改善血管胎记的去除。激光器Surg.Med.©2018Wiley期刊，Inc.
方法：本IRB批准，观察性临床试验在3个月至73岁的健康志愿者中进行.所有患者均接受了婴儿血管瘤或PWB的激光治疗，皮肤类型为FitzpatrickI-V。治疗前后进行49例血管瘤的OCT成像和PWB扫描。测量构成血管病变的血管的直径和深度。此外,扫描正常皮肤进行比较.分析了五个婴儿血管瘤的数据集和五个没有运动伪影的PWB的数据集。
结果：扫描的病变表现出可变和高度异质的血管模式，血管直径范围为20至160μm，这表明单脉冲持续时间的激光治疗可能不是最佳的。观察到的最大血管直径（160μm）可能无法通过常用的脉冲染料激光脉冲持续时间充分处理。
结论：OCT允许快速，在单个血管病变中血管直径和深度的非侵入性表征。成像病变由血管大小的异质性群体组成，形态学,和深度。未来的研究可以利用这些信息来帮助开发个性化的治疗方案，以改善血管胎记的去除。激光器Surg.Med.©2018Wiley期刊，Inc.
