title: Indocyanine green fluorescence imaging for evaluation of uterine blood flow in cynomolgus macaque.
abstract: BACKGROUND
  Uterine blood flow is an important factor in uterine viability, but the number of blood vessels required to maintain viability is uncertain. In this study, indocyanine green (ICG) fluorescence imaging was used to examine uterine hemodynamics and vessels associated with uterine blood flow in cynomolgus macaque.
  
  
  METHODS
  The uterus of a female cynomolgus macaque was cut from the vaginal canal to mimic a situation during trachelectomy or uterine transplantation surgery in which uterine perfusion is maintained only with uterine and ovarian vessels. Intraoperative uterine hemodynamics was observed using ICG fluorescence imaging under conditions in which various nutrient vessels were selected by clamping of blood vessels. A time-intensity curve was plotted using imaging analysis software to measure the T(max) of uterine perfusion for selected blood vessel patterns. Open surgery was performed with the uterus receiving nutritional support only from uterine vessels on one side. The size of the uterus after surgery was monitored using transabdominal ultrasonography.
  
  
  RESULTS
  The resulting time-intensity curves displayed the average intensity in the regions of the uterine corpus and uterine cervix, and in the entire uterus. Analyses of the uterine hemodynamics in the cynomolgus macaque showed that uterine vessels were significantly related to uterine perfusion (P=0.008), whereas ovarian vessels did not have a significant relationship (P=0.588). When uterine vessels were clamped, ovarian vessels prolonged the time needed to reach perfusion maximum. Postoperative transabdominal ultrasonography showed that the size of the uterus was not changed 2 months after surgery, with recovery of periodic menstruation. The cynomolgus macaque has got pregnant with favorable fetus well-being.
  
  
  CONCLUSIONS
  Uterine vessels may be responsible for uterine blood flow, and even one uterine vessel may be sufficient to maintain uterine viability in cynomolgus macaque. Our results show that ICG fluorescence imaging is useful for evaluation of uterine blood flow since this method allows real-time observation of uterine hemodynamics.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Iori
authors.initials: I
authors.lastname: Kisu
authors.forename: Kouji
authors.initials: K
authors.lastname: Banno
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Lin
authors.forename: Kosuke
authors.initials: K
authors.lastname: Tsuji
authors.forename: Megumi
authors.initials: M
authors.lastname: Yanokura
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Takayuki
authors.initials: T
authors.lastname: Abe
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kouyama
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Suganuma
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000818:Animals; D005260:Female; D005451:Fluorescein Angiography; D006439:Hemodynamics; D007208:Indocyanine Green / Q000737:chemistry*; D008252:Macaca fascicularis; D011247:Pregnancy; D012984:Software; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000637:transplantation
chemical_list: D007208:Indocyanine Green