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使用多En Face图像平均光学相干断层扫描血管造影进行脉络膜毛细血管成像

Uji, A., Balasubramanian, S., Lei, J., Baghdasaryan, E., Al-Sheikh, M., Sadda, S.R.

期刊名称:JAMA Ophthalmology

卷期:2017年第135卷第11期

摘要

摘要:重要性:现有技术对脉络膜毛细血管内成像具有挑战性。光学相干断层扫描血管造影(OCTA),如果优化的话,可以使成像面临的挑战减少。目的:旨在调查脉络膜毛细血管内多en face图像OCTA图像平均叠加技术。设计,设置和研究对象:在加利福尼亚州洛杉矶的一家机构进行了一项观察性,横断面病例系列研究。在一项21名健康个体的原始队列中,17名受试者的17只正常眼包括在该研究中。研究日期为20168月至9月。所有参与者均使用OCTA软件(Cirrus 5000AngioPlex; Carl Zeiss Meditec)进行黄斑区3×3-mm区域OCTA成像。每个参与者的一只眼重复成像以获得9OCTA立方体扫描组。首先使用浅表毛细血管丛图像进行配准,然后将这种转换应用于脉络膜毛细血管图像。然后对9个登记的脉络膜毛细血管图像进行平均计算。在二值化OCTA图像上测量定量参数并与未平均OCTA图像进行比较。主要预后指标:血管直径。结果:17名受试者(平均年龄[SD]35.1 [6.0]]9名女性[53];以及9[53]白人)的17只眼进行了测量。单一的未平均图像表现出颗粒状外观,并且血管类型难以辨别。平均之后,en face脉络膜毛细血管图像呈网状外观。血管平均(SD)直径22.85.8)微米(范围,9.6-40.2微米)。与单个未平均图像相比,平均图像显示更多的流动空隙(1423流动空隙[95CI967-1909]1254流动空隙[95CI825-1683]P <.001 911 [95CI301-1521]μm2vs 1364 [95CI645-2083]μm2P <0.001)和更大血管密度(70.7[95CI61.9 79.5]61.9[95CI56.0-67.8]P <.001)。在无平均图像和平均图像中,流动空隙的数量与大小的分布是不对称。与未平均图像相比,平均图像的线性对数 - 对数图显示平均图像中分布更均匀。结论和相关性:多次en face平均可改善健康志愿者OCTA图像上的脉络膜毛细血管的可视化,将图像从粒状外观转变为可显示血管内空间的水平。

Importance:Imaging of the choriocapillaris in vivo is challenging with existing technology. Optical coherence tomography angiography (OCTA), if optimized, could make the imaging less challenging.Objective:To investigate multiple en face image averaging on OCTA images of the choriocapillaris.Design, Setting, and Participants:Observational, cross-sectional case series at a referral institutional practice in Los Angeles, California. From the original cohort of 21 healthy individuals, 17 normal eyes of 17 participants were included in the study. The study dates were August to September 2016.Exposures:All participants underwent OCTA imaging of the macula covering a 3×3-mm area using OCTA software (Cirrus 5000 with AngioPlex; Carl Zeiss Meditec). One eye per participant was repeatedly imaged to obtain 9 OCTA cube scan sets. Registration was first performed using superficial capillary plexus images, and this transformation was then applied to the choriocapillaris images. The 9 registered choriocapillaris images were then averaged. Quantitative parameters were measured on binarized OCTA images and compared with the unaveraged OCTA images.Main Outcome and Measure:Vessel caliber measurement.Results:Seventeen eyes of 17 participants (mean [SD] age, 35.1 [6.0] years; 9 [53%] female; and 9 [53%] of white race/ethnicity) with sufficient image quality were included in this analysis. The single unaveraged images demonstrated a granular appearance, and the vascular pattern was difficult to discern. After averaging, en face choriocapillaris images showed a meshwork appearance. The mean (SD) diameter of the vessels was 22.8 (5.8) μm (range, 9.6-40.2 μm). Compared with the single unaveraged images, the averaged images showed more flow voids (1423 flow voids [95% CI, 967-1909] vs 1254 flow voids [95% CI, 825-1683], P<.001), smaller average size of the flow voids (911 [95% CI, 301-1521] μm2 vs 1364 [95% CI, 645-2083] μm2, P<.001), and greater vessel density (70.7% [95% CI, 61.9%-79.5%] vs 61.9% [95% CI, 56.0%-67.8%], P<.001). The distribution of the number vs sizes of the flow voids was skewed in both unaveraged and averaged images. A linear log-log plot of the distribution showed a more homogeneous distribution in the averaged images compared with the unaveraged images.Conclusions and Relevance:Multiple en face averaging can improve visualization of the choriocapillaris on OCTA images, transforming the images from a granular appearance to a level where the intervascular spaces can be resolved in healthy volunteers.


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