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Updated: Dec 15, 2025

Author Spotlight: Advancing Spectral Characterization of Physiological and Malperfused Tissues
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Intraoperative Imaging Techniques to Visualize Hepatic (Micro)Perfusion: An Overview.

Zühre Uz1,2, Lucinda Shen3,4, Dan M J Milstein5

  • 1Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands, uz.zuhre@gmail.com.

European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes
|July 14, 2020
PubMed
Summary

Assessing liver perfusion intraoperatively is vital for understanding liver health. This review covers advanced imaging techniques like ultrasound, vital microscopy, and fluorescence angiography for real-time microcirculation evaluation.

Keywords:
Hepatic microcirculationImaging techniquesIntraoperative perfusion imagingPerfusion

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Area of Science:

  • Hepatology
  • Medical Imaging
  • Microcirculation Research

Background:

  • Microcirculation is key for organ perfusion.
  • Dysfunction in microcirculation predicts morbidity and mortality.
  • Liver perfusion assessment reveals the liver's physiological state.

Purpose of the Study:

  • To review intraoperative perfusion imaging techniques for the liver.
  • To discuss the advantages, disadvantages, and applications of these methods.

Main Methods:

  • Dynamic contrast-enhanced ultrasound (DCE-US) for deep tissue and tumor perfusion.
  • Handheld vital microscopy for direct visualization of liver sinusoidal architecture.
  • Indocyanine green (ICG) fluorescence angiography for microvascular perfusion.
  • Laser speckle contrast imaging (LSCI) for non-contact, large-area tissue perfusion.

Main Results:

  • DCE-US is valuable for tumor perfusion assessment.
  • Vital microscopy offers unique visualization of liver sinusoids.
  • ICG fluorescence angiography visualizes microvascular perfusion using near-infrared light.
  • LSCI provides artifact-free perfusion imaging over large areas.

Conclusions:

  • Various intraoperative perfusion imaging techniques offer distinct advantages for liver assessment.
  • These modalities provide critical insights into liver (patho)physiology.
  • Understanding these techniques aids in clinical and scientific applications for liver health.