光学相干断层扫描术在先天性胫骨假关节诊断中的应用  

Application of optical coherence tomography in the diagnosis of congenital pseudarthrosis of tibia

作　　者：牛学强[1] 刘洋 刘福云[1] 胡伟明[1] 屈玉冉 文龙 Niu Xueqiang;Liu Yang;Liu Fuyun;Hu Weiming;Qu Yuran;Wen Long(Department of Orthopedics,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第三附属医院骨科,450000

出　　处：《中华实用儿科临床杂志》2021年第7期529-532,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划项目(201602134)。

摘　　要：目的探讨光学相干断层扫描术(OCT)在先天性胫骨假关节(CPT)患儿诊断中应用的可行性。方法选取2016年1月至2019年12月于郑州大学第三附属医院就诊的Ⅰ型神经纤维瘤(NF1)并CPT患儿10例为试验组,骨组织标本取下经术中观察及评估后即行OCT扫描,并与常规组织学检查进行对比。同期留取5例引产的非NF1且非CPT胎儿的骨组织标本为对照组,同样进行上述检查,对比试验组与对照组骨组织的检查结果。结果与对照组骨组织标本相比,试验组骨组织标本可见骨小梁增粗,部分骨小梁融合,排列紊乱,间质纤维组织增生并脂肪化。OCT扫描可直接显示骨组织中神经、血管,散在脂肪组织,对照组骨组织标本排列整齐、致密、规则的阴影,试验组骨组织标本可见折光性较强、排列疏松、紊乱的破骨细胞、纤维骨化,散在的神经、血管及空泡状的脂肪细胞成分增多。结论OCT可快速、清晰扫描新鲜离体组织,并直接显示组织内部结构,与常规病理学检查契合度较高,可为CPT患儿的病理学诊断做有效补充,同时为后续基因学研究保留样本。Objective To explore the feasibility of the application of optical coherence tomography(OCT)in the diagnosis of congenital pseudarthrosis of tibia(CPT)in children.Methods Ten children with neurofibromatosis typeⅠ(NF1)and CPT were treated in the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2019,and enrolled as the experimental group.The bone tissue samples were collected and subjected to OCT scanning after intraoperative observation and evaluation,and were contrasted with conventional histological examination.During the same period,the bone tissues of 5 non-NF1 and non-CPT induced-labor fetuses were collected as the control group for the above examination,and the bone tissue examination results of the experimental group and the control group were compared as well.Results Compared with the bone tissues of the control group,that of the experimental group displayed thickening trabecular bone,part of trabecular bone fusion,disordered arrangement,proliferation and fatification of interstitial fibrous tissue.OCT scan can directly show the nerves and blood vessels in the bone tissue,scattered in adipose tissue.OCT scan showed that the bone tissues of the control group were neatly arranged,with dense and regular shadows.The bone tissues of the experimental group could be observed with strong refraction,loose arrangement,and disordered bone fractures,fibrous ossification,scattered nerves,blood vessels,and increased vacuolar fat cells.Conclusions OCT can quickly and clearly scan the freshly isolated tissues and directly display the internal structure of the tissues.It is highly compatible with routine pathological examinations and can be an effective supplement to the pathological diagnosis of children with CPT and retain samples for subsequent genetic studies.

关 键 词：神经纤维瘤病 先天性胫骨假关节 光学相干显微成像 组织学检查 

分 类 号：R726.8[医药卫生—儿科]