Download PDF
Phlebologie 2000; 29(03): 62-66
DOI: 10.1055/s-0037-1617237
Originalarbeit
Schattauer GmbH

Objektivierung kutaner Mikrozirkulationsstörungen bei akralen vaskulären Erkrankungen mittels Laser-Doppler- Perfusion-Imaging

M. Stücker
1   Dermatologische Klinik der Ruhr-Universität Bochum (Direktor: Prof. Dr. P. Altmeyer)
,
P. Sander
1   Dermatologische Klinik der Ruhr-Universität Bochum (Direktor: Prof. Dr. P. Altmeyer)
,
O. Köster
2   Radiologische Klinik der Ruhr-Universität Bochum (Direktor: Prof. Dr. O. Köster)
,
P. Altmeyer
1   Dermatologische Klinik der Ruhr-Universität Bochum (Direktor: Prof. Dr. P. Altmeyer)
› Author Affiliations
Further Information

Publication History

Publication Date:
29 December 2017 (online)

    Permissions and Reprints

Zusammenfassung

Periphere arterielle Verschlüsse lassen sich mittels der arteriellen digitalen Subtraktionsangiographie (DSA) darstellen. Methode: In der vorliegenden Fallstudie verglichen wir die invasive Technik der arteriellen DSA mit dem nichtinvasiven zweidimensionalen Laser-Doppler- Perfusion-Imaging. Ergebnis: Bei 2 Patienten mit Thrombangitis obliterans entsprachen den Arterienabbrüchen Areale mit verminderten Fluxwerten im LDPIBild. Eine Patientin mit Livedo-Vaskulitis zeigte hingegen eine vermehrte Gefäßkontrastierung und vermehrten Kontrastmittelfluß in der DSA, aber Areale mit verminderten Fluxwerten im LDPI-Bild. Histologisch entsprachen den offenen Lumina der subkutanen Arterien hingegen hyaline Thromben der korialen Arteriolen. Schlußfolgerung: Insgesamt erfaßt das LDPI offenbar selektiv die kutane Perfusion. Da das Verfahren nicht invasiv ist, ermöglicht es wiederholte Verlaufskontrollen.

Summary

Peripheral arterial occlusions can be demonstrated by arterial digital subtraction angiography. Method: In this study we compared arterial angiography with twodimensional laser Doppler perfusion imaging (LDPI). Result: In two patients who suffered from Buerger’s disease, the arterial occlusions corresponded well with areas of low flow values in LDPI. The patient with livedo vasculitis indicated an increased vascular contrast and an increased passage of contrast medium in angiography, while the same areas in LDPI were described by decreased flow. In histology these areas were described by open lumina of subcutaneous arteries while superficial corial venules in the same lesions showed hyaline thrombi. Conclusion: In LDPI the major part of the signal is generated in cutaneous vessels. Follow up studies and therapy controlling by non-invasive LDPI seem to be reasonable as well as worthwhile.

Résumé

Des occlusions arterielles péripheriques peuvent être visualisées par la technique de l’angiographie numerisé. Méthode: Dans cet étude nous avons comparé l’angiographie numerisé avec laser-Doppler scanning (LDPI), qui est une méthode deuxdimensionelle. Résultat: Deux patients qui souffraient d’une thromboangéite oblitérante ont montré des areals avec un flux reduit, qui correspondaient aux occlusions arterielles. Le patient avec une vascularite de type livedo a montré un contraste augmenté des vaisseaux et un passage acceleré du moyen contraste, contre quoi les mêmes areals montraient un flux reduit dans LDPI. Dans l’histologie ces areals montraient des lumina ouverts des artères souscutanées, bienque les venules coriales superficielles etaient occlusées par des thrombes hyalines. Conclusions: Dans la technique de LDPI la plupart du signal est generé par les vaisseaux cutanés. Des études du type Follow up peuvent être controllés par cette technique noninvasive.

Schlüsselwörter

Laser-Doppler-Scanning - digitale Subtraktionsangiographie - kutane Mikrozirkulation - Thrombangitis obliterans - Livedo-Vaskulitis

Keywords

Laser-Doppler scanning - angiography - cutaneous microcirculation - Buerger’s disease - livedo vasculitis

Mots clés

Laser-Doppler scanning - angiographie numerisé - microcirculation cutanée - thromboangéite oblitérante - vascularite de type livedo
 

  • Literatur

  • 1 Bollinger A, Butti P, Barras JP, Trachsler H. Red blood cell velocity in nailfold capillaries of man measured by a television microscopy technique. Microvasc Res 7: 61-72.
    Google Scholar
  • 2 Braverman IM, Schner JS. Contour mapping of the cutaneous microvasculature by computerized laser Doppler velocimetry. J Invest Dermatol 1991; 97: 1013-8.
    CrossrefPubMedGoogle Scholar
  • 3 Erikssen M, Lossius K. Inadequacy of laser- Doppler-flowmetry in areas of the human hand. Med Biol Eng Comput 1993; 31: 311-8.
    CrossrefPubMedGoogle Scholar
  • 4 Gush RJ, King TA. Discrimination of capillary and arterio-venular blood flow in skin by laser Doppler flowmetry. Med Biol Eng Comput 1991; 29: 387-92.
    CrossrefPubMedGoogle Scholar
  • 5 Jakobsson A, Nilsson GE. Prediction of sampling depth and photon wavelength in laser Doppler flowmetry. Med Biol Eng Comput 1993; 31: 301-7.
    CrossrefPubMedGoogle Scholar
  • 6 Nilsson G, Tenland T, Öberg PA. Evaluation of a laser-Doppler flowmeter for measuring tissue blood flow. IEEE Trans Biomed Eng 27: 12-8.
    Google Scholar
  • 7 Shepard AP, Öberg PA. Laser Doppler blood flowmetry. Kluwers Academic Publications: Boston; 1990
    PubMedGoogle Scholar
  • 8 Shepard AP, Riedel GL, Klie JW, Haumschild DJ, Maxwell LC. Evaluation of an infrared laser Doppler flowmeter. Am J Physiol 1987; 252: G832-9.
    Google Scholar
  • 9 Stücker M, Auer T, Hoffmann K, Altmeyer P. Spatial pattern of cutaneous perfusion in wound healing. In: Altmeyer P, Hoffmann K, el Gammal S, Hutchinxon T. (eds.) Wound Healing. Springer: Heidelberg.;
    Google Scholar
  • 10 Stücker M, Auer T, Hoffmann K, Altmeyer P. Two dimensional blood flow determinations in allergic reactions using laser-Doppler Scanning. Contact Dermatitis 1995; 33: 58-64.
    CrossrefPubMedGoogle Scholar
  • 11 Stücker M, Heese A, Hoffmann K, Altmeyer P. Quantification of vascular dysregulation in atopic dermatitis using Laser Doppler Scanning. Skin Res Technol 1998; 4: 9-13.
    CrossrefPubMedGoogle Scholar
  • 12 Stücker M, Heese A, Röchling A, Hoffmann K, Altmeyer P. Precision of laser Doppler scanning in clinical use. J Clin Exp Dermatol 1995; 20: 371-6.
    CrossrefPubMedGoogle Scholar
  • 13 Stücker M, Reuther T, Hoffmann K, Altmeyer P. Quantification of cutaneous pharmacological reactions: comparison of laser-Doppler-Scanning, colorimetry, planimetry and skin temperature measurement. Skin Res Technol 1996; 2: 12-7.
    CrossrefPubMedGoogle Scholar
  • 14 Stücker M, Reuther T, Hoffmann K, Jeske M, Altmeyer P. Nicht-invasive Evaluierung der kutanen Mikrozirkulation. Akt Dermatol 1995; 21: 4-10.
    Google Scholar
  • 15 Stücker M, Jeske M, Hoffmann K, Altmeyer P. Laser-Doppler-Scanning bei progressiver Sklerodermie. Phlebologie 1995; 24: 9-14.
    Google Scholar
  • 16 Tenland T, Salerud G, Nilsson GE. Spatial and temporal variations in human skin blood flow. Int J Microc Clin Exp 1983; 2: 81-90.
    Google Scholar
  • 17 Tooke JE, Östergren J, Fagrell B. Synchronous assessment of human skin microcirculation by laser Doppler flowmetry and dynamic capillaroscopy. Int J Microcirc: Clin Exp 1983; 2: 277-84.
    PubMedGoogle Scholar
  • 18 Wardell K. Laser Doppler Perfusion Imaging. Thesis N, 308. Department of Biomedical Engineering. Linköping University, Sweden 1992
    PubMedGoogle Scholar
  • 19 Wardell K, Jakobsson A, Nilsson GE. Laser Doppler perfusion imaging by dynamic light scattering. IEEE Trans Biomed Eng 1993; 40: 309-16.
    CrossrefPubMedGoogle Scholar