title: In vivo Doppler optical coherence tomography of mucocutaneous telangiectases in hereditary hemorrhagic telangiectasia.
abstract: BACKGROUND
  Hereditary hemorrhagic telangiectasia is characterized by mucocutaneous telangiectases and visceral arteriovenous malformations. Knowledge is limited concerning the development hemodynamics of mucocutaneous telangiectases. Doppler optical coherence tomography can demonstrate microvascular blood flow at flow rates as low as 20 microm/second, which is up to approximately 100 times more sensitive than Doppler US. The aims of this study were to collect in vivo Doppler optical coherence tomography images of mucocutaneous telangiectases and normal surrounding mucosa and skin, and to gain experience for an in vivo GI endoscopic study. It was hypothesized that visibly normal areas may have occult telangiectases and that mucocutaneous telangiectases that have bled may have a higher rate of blood flow than mucocutaneous telangiectases with no history of bleeding.
  
  
  METHODS
  Twelve patients with hereditary hemorrhagic telangiectasia and mucocutaneous telangiectases were studied. Two to 3 visible mucocutaneous telangiectases on the digits, lips, and tongue were imaged with Doppler optical coherence tomography, along with visually normal surrounding areas at each site. The Doppler optical coherence tomography images were obtained in 0.5 second by using 1310 nm light.
  
  
  RESULTS
  A total of 67 mucocutaneous telangiectases from the 12 patients were imaged (38 digit, 16 lip, 13 tongue). Blood flow was demonstrated within every mucocutaneous telangiectasis imaged. Doppler optical coherence tomography did not identify any abnormal vasculature within visually normal areas. Mucocutaneous telangiectases with a history of bleeding (n = 18) were situated closer to the surface, compared with mucocutaneous telangiectases with no bleeding history (n = 49), but there was no difference in the Doppler flow appearance.
  
  
  CONCLUSIONS
  Visually normal areas in patients with hereditary hemorrhagic telangiectasia did not appear to have abnormal vasculature. Mucocutaneous telangiectases with a history of bleeding were more superficial but were otherwise similar to mucocutaneous telangiectases with no bleeding history.
authors.affiliation: Center for Therapeutic Endoscopy and Endoscopic Oncology, Division of Respiratory Medicine, Department of Medicine, St. Michael's Hospital, Ontario, Canada.
authors.forename: Shou-Jiang
authors.initials: SJ
authors.lastname: Tang
authors.forename: Maggie L
authors.initials: ML
authors.lastname: Gordon
authors.forename: Victor X D
authors.initials: VX
authors.lastname: Yang
authors.forename: Marie E
authors.initials: ME
authors.lastname: Faughnan
authors.forename: Maria
authors.initials: M
authors.lastname: Cirocco
authors.forename: Bing
authors.initials: B
authors.lastname: Qi
authors.forename: Emily Seng
authors.initials: ES
authors.lastname: Yue
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Gardiner
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Haber
authors.forename: Gabor
authors.initials: G
authors.lastname: Kandel
authors.forename: Paul
authors.initials: P
authors.lastname: Kortan
authors.forename: Alex
authors.initials: A
authors.lastname: Vitkin
authors.forename: Brian C
authors.initials: BC
authors.lastname: Wilson
authors.forename: Norman E
authors.initials: NE
authors.lastname: Marcon
mesh_terms: D000328:Adult; D004301:Doppler Effect; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000175:diagnosis* / Q000503:physiopathology; D041623:Tomography, Optical Coherence