在猪模型中使用稀释 10 倍的静脉注射吲哚菁绿溶液可在关节镜下观察半月板的血流情况

Tamiko Kamimura M.D., Ph.D.
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引用次数: 0

摘要

目的 确定在猪模型中使用 ICG 荧光引导膝关节镜评估半月板血管所需的最佳吲哚菁绿(ICG)剂量。用 2.0 mL 5×、10×、100× 和 1,000× 稀释溶液静脉注射 ICG(25 mg)。考虑到最佳稀释设置的结果,还进行了另一项实验来评估半月板内的微血管。特意在内侧半月板的中后部诱发径向撕裂,以观察半月板横截面上的血管情况;使用最佳 ICG 稀释液。用 10 倍稀释的 ICG 在滑膜前部和前十字韧带可观察到荧光。将 ICG 稀释 5 倍后,对比度增强过于强烈,无法进行观察。因此,10 倍稀释溶液被认为是膝关节镜检查和观察桡侧撕裂的最佳设置。内侧半月板横截面未观察到荧光。通过刺激撕裂部位附近的荧光染色滑膜可观察到动脉出血。结论 膝关节镜检查中 ICG 的最佳稀释和剂量设置为 10 倍,静脉注射量为 2.0 毫升。即使在红-红区,半月板也没有活跃的血流。这项研究可以确定一种适合 ICG 荧光引导膝关节镜检查的 ICG 溶液。这一发现对未来研究关节镜下特定病例的半月板血管化很有价值,尤其是将这些发现应用于人体半月板治疗。
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Blood Flow in the Meniscus Can Be Visualized Arthroscopically Using an Intravenous Indocyanine Green Solution Diluted 10× in a Pig Model

Purpose

To determine the optimal indocyanine green (ICG) dose required for assessing vascularity in the meniscus using ICG fluorescence-guided knee arthroscopy in a pig model.

Methods

A 3-month-old Japanese esculent female pig was used in this study. Intravenous injections of ICG (25 mg) were administered with 2.0 mL of 5×, 10×, 100×, and 1,000× diluted solutions. An additional experiment was conducted to assess the microvasculature within the meniscus considering the results of the optimal dilution setting. A radial tear was purposely induced in the middle-to-posterior section of the medial meniscus to observe vascularity in the cross-sectioned meniscus; the optimal ICG dilution was administered.

Results

No fluorescence was detected in the meniscus with solutions diluted by 1,000× and 100×. Fluorescence was visualized at the anterior portion of the synovium and the anterior cruciate ligament using ICG diluted by 10×. Diluting ICG by 5×, contrast enhancement was too intense for observation. Therefore, the 10× diluted solution was considered the optimal setting for knee arthroscopy and observation of the radial tear. No fluorescence was observed in the cross section of the medial meniscus. Arterial hemorrhage was observed by stimulating the fluorescence-dyed synovium adjacent to the tear site. Through the additional waiting time after stimulating the tear site, the hemorrhage inside the meniscus became more intense.

Conclusions

The optimal dilution and dose setting of ICG for knee arthroscopy was 10× in a 2.0-mL intravenous injection. The meniscus showed no active blood flow, even in the red-red zone. This finding might support the notion that blood flow cannot be initiated, without synovial stimulation, even in vascular areas.

Clinical Relevance

This study could determine an ICG solution suitable for ICG fluorescence-guided knee arthroscopy. This finding could be valuable in future research focusing on case-specific meniscal vascularization under arthroscopy, particularly applying these findings to human meniscal treatment.

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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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