Laser doppler tissue flowmetry : fiberoptic methods in microvascular research

Abstract: Laser Doppler flowmetry (LDF) constitutes a method for measuring the flux of blood cells in the microcirculatory bed. Photons are scattered in the moving blood cells, where they undergo a frequency shift according to the Doppler principle. Light is brought to the tissue under study by one optical fiber and transmitted back to photodetectors by two separate fibers. LDF is a particulary useful method to study blood flow patterns and vascular regulatory mechanisms, since it is non-invasive and assesses blood flow in a very small volume of tissue (1 mm3).Blood flow recordings from skin areas, such as forearm and forehead, have revealed large spatial and temporal variations in microvascular blood flow. If the flowmeter probe is moved as little as 2.5 mm, the spatial heterogeneity of the vasculature result in a significant (p<0.001) difference in flowmeter output signal.Spontaneous rhythmical blood flow patterns (vasomotion) with different amplitudes, appeared in all of the 8 subjects studied. Some subjects had a continuous vasomotion pattern, while others showed only "bursts" of the pattern. Recorded blood flow in two juxtaposed skin sites sometimes demonstrated simultaneous variations in both sites, while in other instances the rhythmical flow patterns were out of phase or of different frequencies. To overcome the problem with a large spatial variation in skin blood flow in relation to the geometrical dimension of the probe, a multifiber probe was developed. It was designed to integrate the blood flow over an area enlarged approximately seven times compared to the standard probe. Measurements with this probe reduced the spatial differences as theoretically expected. No averaging effect was found, however, on the temporal variations.In skin, the capillary bed is located superficially, while in other tissues, such as the intestine, the inner wall (mucosa) is the most perfused. In an experiment on cat small intestine, the blood flow was measured both from the mucosal and serosal side. The results showed that it was possible to record the total blood flow of the intestinal wall, irrespective of whether the probe was placed on the mucosal or serosal side of the bowel wall.For tissues like muscle, liver and brain it may be of interest to assess the deep tissue perfusion. The LDF standard probes are, however, too large and blunt to be inserted into the tissue, without disturbing the flow. Therefore a single fiber LDF was developed, with oneoptical diber (Ø =0.5 mm) guiding the light to and from the tissue under study. In a flow model resembling tissue perfusion, the usefulness of the single fiber LDF based on the differential technique was evaluated. When a mathematical model was used to evaluate the single versus the differential channel operation, the differential technique was found most powerful if the laser broadband noise has a substantial rms-value or if many coherence areas are detected. The dynamic responses of the single fiber LDF were studied in a pig experimental model under different physiological conditions. The results agreed well with known reference blood flow patterns