重视光相干断层扫描血流成像的临床应用及其图像的判读

Paying attention to the clinical application and image interpretation in optical coherence tomography angiography

光相干断层扫描血流成像（OCTA）是在OCT的基础上发展而来的眼病诊断新技术，也是目前眼科影像学检查中发展最快速的检查方法之一。目前，对眼底血管性疾病的主要检查方法包括荧光素眼底血管造影（FFA）和吲哚青绿血管造影（ICGA），具有对血管异常动态显现的特点，能对异常血管形态和病变特征提供有用的诊断信息，但其为有创的检查方法，且无法对病变进行分层分析。与FFA和ICGA相比，OCTA除了具备无创、快速、高分辨率的特点外，还具有无创性对血流显影的能力，其不受血管渗漏和视网膜出血的影响，能够提供三维测量的病变图像，并能实现病变的定量检测和分层检测，目前已用于多种眼科疾病的诊断和病情监测。OCTA技术的临床应用丰富了眼科影像学对疾病的诊疗信息及发病机制的探索结果。OCTA的检测过程和正确判读是基于对其原理和眼部待测组织解剖知识的理解和掌握，因此理解其原理及临床应用是临床眼科医师的必修课程。

Optical coherence tomography angiography （OCTA） is a new diagnostic technique in recent years based on the OCT, and it is one of the fastest developing imaging examinations in ophthalmology.At present, the primary diagnostic methods of retinal neovascular diseases are fundus fluorescein angiography （FFA） and indocyanine green angiography （ICGA）, which can dynamically exhibit the abnormal vessels and provide visible abnormal vascular morphology and useful diagnostic information.However, FFA and ICGA are invasive ways, and these methods are unable to perform layer analysis.Compared with FFA and ICGA, in addition to the features of non-invasive, high-speed scanning and high-resolution, OCTA also shows the ability to reveal blood flow non-invasively.OCTA is not affected by vascular leakage or retinal hemorrhage, and it can give the three dimensionally measuring image and achieve quantitative and enface analysis of lesion.The utility of OCTA technique enriches and accelerates the imaging diagnosis, treatment and exploration of the ocular diseases.However, the measuring procedure and accurate interpretation of OCTA depends on the correct understanding for OCTA principle and tissue structure.Therefore, it is essential for an ophthalmologist to fully study and know its principles and clinical application.