BACKGROUND Intraoperative indocyanine green videoangiography (ICG-VA) has been reported to be utilized in various cerebrovascular surgeries, wherein the blood flow is noticeably shown in white with a black background. ICG flow alone, but not other structures, can be observed using ICG-VA. We developed a novel high-resolution intraoperative imaging system using laser light source for simultaneously visualizing both visible light and near-infrared (NIR) fluorescence images of ICG-VA. METHODS We used a novel system for 14 cerebrovascular cases. The operative field was illuminated via an operating microscope using a novel laser light source with four bands at 464 (blue), 532 (green), 640 (red), and 785 nm (NIR region). The observed light from the operative field was split using a beam splitter cube into visible (420- 660 nm) and NIR fluorescence emission light (832-900 nm). Images from the color video and NIR fluorescence emission windows were merged for visualization on a monitor screen simultaneously. Laser light was compared with xenon light, and both setups were tested for cerebrovascular surgeries. RESULTS Laser light has numerous advantages over xenon light. The present setup clearly visualized the color operative field with enhanced blood flow. Complete clipping or incomplete clipping with neck remnant or remnant flow into an aneurysm was confirmed in aneurysm surgeries. Feeding arteries and draining veins were easily distinguished in case of arteriovenous malformation. CONCLUSIONS Using the present setup, we can observe the color operative field and enhanced blood flow using ICG in real time. This setup could facilitate various cerebrovascular surgeries.

中文翻译：

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一种新型术中激光成像系统，可同时可视化吲哚菁绿色视频血管造影的可见光和近红外荧光。

背景技术据报道，术中吲哚菁绿视频血管造影术（ICG-VA）已用于各种脑血管手术中，其中血流明显显示为白色，黑色背景。使用ICG-VA只能观察到ICG流动，而不能观察其他结构。我们开发了一种新颖的高分辨率术中成像系统，该系统使用激光光源同时可视化了ICG-VA的可见光和近红外（NIR）荧光图像。方法我们对14例脑血管病例使用了一种新型系统。通过使用新型激光光源的手术显微镜对手术视野进行照明，该激光光源在464（蓝色），532（绿色），640（红色）和785 nm（NIR区域）具有四个波段。使用分束器立方体将来自手术区域的观察光分成可见光（420-660 nm）和近红外荧光发射光（832-900 nm）。来自彩色视频和NIR荧光发射窗口的图像被合并，以便同时在监视器屏幕上显示。将激光与氙气进行了比较，并测试了两种设置的脑血管手术。结果激光比氙气具有许多优势。本装置清楚地显示了彩色手术区域的增强血流。在动脉瘤手术中证实了完全切除或不完全切除，残留有颈部或残留流到动脉瘤中。在动静脉畸形的情况下，容易区分进食动脉和引流静脉。结论使用目前的设置，我们可以使用ICG实时观察彩色手术视野和增强的血流。这种设置可以促进各种脑血管手术。