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New publications

Newly published research articles from the photoacoustic center.

Original articles on perfusion monitoring during oculoplastic reconstructive surgery

Wiktorin AHC, JV Berggren, M Malmsjo, S Lindstedt, R Sheikh &  E Bohman (2022): Mapping of Perfusion During Full-Thickness Blepharotomy Using Laser Speckle Contrast Imaging. Ophthalmic Plast Reconstr Surg.

The aim of this study was to monitor how the blood perfusion in human upper eyelids is affected during full-thickness blepharotomy. Eyelid perfusion was mapped during full-thickness blepharotomy using laser speckle contrast imaging. The results showed that perfusion is sufficiently preserved during surgery, probably due to the rich vascular supply in the periocular region, which may explain the low risk of postoperative complications such as ischemia and infection.

Berggren JV, K Tenland, R Sheikh, J Hult, K Engelsberg, S Lindstedt &  M Malmsjo (2022): Laser Speckle Contrast Imaging of the Blood Perfusion in Glabellar Flaps Used to Repair Medial Canthal Defects. Ophthalmic Plast Reconstr Surg 38: 274-279.

The glabellar flap is a common technique for surgical repair after tumor excision in the medial canthal area. However, the outcome may be affected by partial flap necrosis. Little is known about the impact of surgery on blood perfusion and the postoperative course of reperfusion due to the absence of reliable and noninvasive perfusion monitoring techniques. The aim of this study was to use a modern imaging technique to assess blood perfusion in glabellar flaps. Perfusion decreased gradually along the length of the flap, and reached a minimum 15 mm from the flap base. Perfusion in the proximal 20 mm of the flap was completely restored after 1 week, while the distal part of the flap was gradually reperfused over 6 weeks. The rapid reperfusion of the glabellar flap may be explained by its connection to the vascular network via the flap pedicle. In flaps longer than 20 mm, the distal part can be considered a free skin transplant, and a combination of a glabellar flap and a free skin graft could then be considered.

 

Original articles on glial cell arteritis

Naumovska M, A Merdasa, B Hammar, J Albinsson, U Dahlstrand, M Cinthio, R Sheikh &  M Malmsjo (2022): Mapping the architecture of the temporal artery with photoacoustic imaging for diagnosing giant cell arteritis. Photoacoustics 27.

One of the main applications of photoacoustic (PA) imaging is to image vascular networks in humans. This relies on the signal obtained from oxygenated and deoxygenated hemoglobin, which limits imaging of the vessel wall itself. Giant cell arteritis (GCA) is a treatable, but potentially sight- and life-threatening disease, in which the artery wall is infiltrated by leukocytes. We present an approach to imaging the temporal artery using multispectral PA imaging. Employing minimally supervised spectral analysis, we produce histology-like images where the artery wall is clearly discernible from the lumen and further differentiate between PA spectra from biopsies diagnosed as GCA- and GCA+ in patients.

Naumovska M, R Sheikh, J Albinsson, B Hammar, U Dahlstrand, M Malmjso &  T Erlov (2022): Ultrasound centre frequency shifts as a novel approach for diagnosing giant cell arteritis. Scand J Rheumatol: 1-8.

Ultrasound centre frequency shift (CFS) is a novel technique that uses high-frequency ultrasound and the analysis of the centre frequency of the ultrasound pulse, which is dependent on the size of the microstructures in the tissue. This provides an objective measure of the scattering microstructures in the tissue, and thus has the potential to discriminate changes due to disease. The aim of this study was to assess ultrasound CFS as a means of discriminating arteries affected by glial cell arthritis (GCA) from healthy arteries. The ultrasound CFS decreased less in temporal artery biopsies positive for GCA than in temporal arteries with a negative biopsy (p < 0.05). This proof-of-principle study indicates that ultrasound CFS has the potential to detect GCA in temporal arteries, but further technical development will be needed before in vivo examination can be performed and the clinical applicability can be assessed.