[The value of optical coherence tomography and morphometry in evaluating the peripancreatic adipose tissue in infected pancreatic necrosis].

Autor:	Ryabkov MG; City Clinical Hospital Thirty, Moskovsky District, Nizhny Novgorod, Russia., Mokeev OA; City Clinical Hospital Thirty, Moskovsky District, Nizhny Novgorod, Russia., Kiseleva EB; Nizhny Novgorod State Medical Academy, Ministry of Health of Russia, Nizhny Novgorod, Russia., Shabanov DV; Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia., Gelikonov VM; Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia., Gelikonov GV; Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia., Spiridonov AA; City Clinical Hospital Thirty, Moskovsky District, Nizhny Novgorod, Russia., Bederina EL; City Clinical Hospital Thirty, Moskovsky District, Nizhny Novgorod, Russia., Gladkova ND; Nizhny Novgorod State Medical Academy, Ministry of Health of Russia, Nizhny Novgorod, Russia., Beschastnov VV; City Clinical Hospital Thirty, Moskovsky District, Nizhny Novgorod, Russia.
Jazyk:	ruština
Zdroj:	Arkhiv patologii [Arkh Patol] 2018; Vol. 80 (3), pp. 46-52.
DOI:	10.17116/patol201880346-52
Abstrakt:	Objective: To investigate the morphometric and optical coherence tomography (OCT) characteristics of the microstructure of retroperitoneal peripancreatic adipose tissue during passive drainage and active perfusion-aspiration drainage for infected pancreatic necrosis. Material and Methods: The authors analyzed 74 samples of peripancreatic adipose tissue obtained from 37 patients with passive (Group 1) and active perfusion-aspiration drainage (Group 2) of a focus of peripancreatitis. The tissues were examined with OCT, then fixed in a formalin solution and underwent histological examination, including morphometric one. Results: The examined groups showed qualitative and quantitative differences in the tissue microstructure. In Group 1 samples, the proportion (median (upper quartile; lower quartile)) of interlobular connective tissue was 5.6 (3.9; 6.1)%; and that of adipocytes was 44.6 (41.2; 51.6)%. Necrotic tissue occupied 46.2 (35.6; 56.1)% of the area of specimens. The OCT images of necrotic tissue displayed a preponderance of unstructured regions with a high signal level while the parenchymal areas showed a cellular structured pattern. In Group 2 samples, the proportion of interlobular connective tissue was 16.2 (11.4; 19.7)%, and that of adipocytes was 68.5 (59.7; 71.2)%. At the same time, Group 2 exhibited necrosis - 14.4 (11.5; 19.2%) that was 3.2 times less than in Group 1. The OCT images of Group 2 samples showed a preponderance of cellular structured regions characteristic of the parenchyma, with pronounced stromal elements, which corresponded to the histological pattern. Conclusion: Active perfusion-aspiration drainage of peripancreatic adipose tissue versus passive drainage is associated with a smaller proportion of necrotic tissue (14.4% versus 46.2%; p≤0.05) and a larger proportion of a stromal vascular component (16.2% vs. 5.6%; p≤0.05). OCT could qualitatively distinguish viable fat tissue parenchyma from necrotic areas, without specially preparing the samples, which was confirmed by histomorphometric results.
Databáze:	MEDLINE
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