基于光学相干成像评估移植肾脏功能研究

Kidney transplantation is one of the most effective treatments for the end stage renal disease (ESRD) since it can save patient life and improve the quality of life. This project proposes to utilize the photonics technique to visualize the correlation between changes in the microstructure and blood flow of the kidney and the function of the donor kidney before and after kidney transplantation. It is critical to explore the preventive interventions for improving the success rate of organ transplantation, which is significant in both the theoretic value and clinical application of organ transplant medicine. It can be expected that following goals will be accomplished through the study of two key scientific questions - (1) the relationship between the optical features of function and structure of donor kidney and the viability of transplanted kidney; (2) the optical characterization of transplanted kidney: building a high speed optical coherent tomography (OCT) system and obtain micro-structures and blood flow data before and after kidney transplant; developing imaging analysis software for kidney OCT; analyzing the correlation between the parameters of kidney microstructures and functions and biochemical examinations of donor kidney and the viability of transplanted kidney; and ultimately obtaining the optical features that can predict the fate of transplanted kidney. It is very likely this study will provide the theoretic insight for kidney transplant surgeons for the novel approach in donor kidney screening and real-time monitoring during the transplant procedure.

肾脏移植是治疗终末期肾病最有效的方法之一。它能显著延长患者生命、提高生活质量。本项目拟凭借可视化光子技术研究移植前后肾脏微结构和血流变化与移植肾脏活性的关联性。探索移植的调控干预，以期提高移植的成活率，具有移植医学的理论价值和临床应用的重要意义。通过对移植肾功能和形态的光学参数与移植肾活性的关联性和评估移植肾脏活性的光学表征等两个关键科学问题的研究，预期可实现如下目标：构建高速光学相干层析成像系统，获取肾脏移植前后的微结构和血流信息；开发肾脏光学相干图像分析软件系统，分析肾脏微结构和功能参数与临床生化指标之间的关联性，以获取表征移植后肾脏活性的光学表达。本项研究成果有望为肾脏移植外科有效遴选供体肾脏和移植过程的实时监测提供一种新模式的理论支持。

肾脏移植是治疗终末期肾病最有效的方法，它能显著延长患者生命、提高生活质量，但是目前还没有可靠有效的方法用于判定供体肾脏的活性。本项目利用OCT技术研究肾脏微结构和血流变化与移植肾脏活性的关联性。主要研究内容包括：(1) 对OCT图像质量进行优化；(2) 对活体动物肾脏OCT成像，建立肾脏组织活性的光学图像表达；(3) 对水肿的动态变化和微血管网络成像进行了多维度研究；(4) 并对人体肾脏移植的供体肾脏的OCT成像进行初步临床研究。主要结果包括：通过OCT三维图像和OCT系统点扩展函数空间分布，可以较好地实现对系统视场分辨率的估计。经过超分辨重建技术的处理，OCT图像的局部信噪比、等效视数、信噪比、互相关值均有提升。通过OCT成像提取肾脏组织光学特性参数，利用光学特性参数的映射图像分析了肾表面组织中各区域的活性状态，建立了肾小管的面密度、体密度以及管径等微结构的量化评价方法。通过散斑方差和互相关血管造影算法复现和改进，算法对小尺度血管分辨更加灵敏，可用于对水肿扩张血管的评估。临床研究显示OCT能直观的观测到肾脏皮质表层的超微结构，近曲小管管腔直径的减少程度可能预示移植后肾功能较差。本项目为肾脏移植中供体肾脏的功能和形态的检测提过了一种新的光学无损检测方法，动物和临床实验结果显示肾脏OCT无损检测具有一定的临床应用价值。项目执行期间已发表中英文论文十三篇。