Comparison between optical coherence tomography imaging and histological sections of peripheral nerves

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Optical coherence tomography (OCT) is an imaging technique that uses the light-backscattering properties of different tissue types to generate an image. In an earlier feasibility study the authors showed that it can be applied to visualize human peripheral nerves. As a follow-up, this paper focuses on the interpretation of the images obtained.


Ten different short peripheral nerve specimens were retained following surgery. In a first step they were examined by OCT during, or directly after, surgery. In a second step the nerve specimens were subjected to histological examination. Various steps of image processing were applied to the OCT raw data acquired. The improved OCT images were compared with the sections stained by H & E. The authors assigned the structures in the images to the various nerve components including perineurium, fascicles, and intrafascicular microstructures.


The results show that OCT is able to resolve the myelinated axons. A weighted averaging filter helps in identifying the borders of structural features and reduces artifacts at the same time. Tissue-remodeling processes due to injury (perineural fibrosis or neuroma) led to more homogeneous light backscattering. Anterograde axonal degeneration due to sharp injury led to a loss of visible axons and to an increase of light-backscattering tissue as well. However, the depth of light penetration is too small to allow generation of a complete picture of the nerve.


OCT is the first in vivo imaging technique that is able to resolve a nerve’s structures down to the level of myelinated axons. It can yield information about focal and segmental pathologies.

ABBREVIATIONS EvG = Elastica van Gieson; NF = neurofilament; OCT = optical coherence tomography; ROI = region of interest.
Article Information

Contributor Notes

Correspondence Anne E. Carolus: University Hospital Knappschaftskrankenhaus Bochum, Germany.; WHEN CITING Published online November 22, 2019; DOI: 10.3171/2019.8.JNS191278.

A.E.C. and J.M. contributed equally to this work.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
  • 1

    Brezinski METearney GJBoppart SASwanson EASouthern JFFujimoto JG: Optical biopsy with optical coherence tomography: feasibility for surgical diagnostics. J Surg Res 71:32401997

    • Search Google Scholar
    • Export Citation
  • 2

    Brill NATyler DJ: Quantification of human upper extremity nerves and fascicular anatomy. Muscle Nerve 56:4634712017

  • 3

    Boppart SA: Optical coherence tomography: technology and applications for neuroimaging. Psychophysiology 40:5295412003

  • 4

    Carolus AELenz MHofmann MWelp HSchmieder KBrenke C: High-resolution in vivo imaging of peripheral nerves using optical coherence tomography: a feasibility study. J Neurosurg [epub ahead of print April 26 2019. DOI: 10.3171/2019.2.JNS183542]

    • Search Google Scholar
    • Export Citation
  • 5

    Huckhagel TNüchtern JRegelsberger JLefering R: Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015. Scand J Trauma Resusc Emerg Med 26:762018

    • Search Google Scholar
    • Export Citation
  • 6

    Inouye HKirschner DA: Evolution of myelin ultrastructure and the major structural myelin proteins. Brain Res 1641 (Pt A):43632016

    • Search Google Scholar
    • Export Citation
  • 7

    Kermarrec EDemondion XKhalil CLe Thuc VBoutry NCotten A: Ultrasound and magnetic resonance imaging of the peripheral nerves: current techniques, promising directions, and open issues. Semin Musculoskelet Radiol 14:4634722010

    • Search Google Scholar
    • Export Citation
  • 8

    Khalil CBudzik JFKermarrec EBalbi VLe Thuc VCotten A: Tractography of peripheral nerves and skeletal muscles. Eur J Radiol 76:3913972010

    • Search Google Scholar
    • Export Citation
  • 9

    Kucenas S: Perineurial glia. Cold Spring Harb Perspect Biol [epub ahead of print] 2015

  • 10

    Landowski LMDyck PJEngelstad JTaylor BV: Axonopathy in peripheral neuropathies: Mechanisms and therapeutic approaches for regeneration. J Chem Neuroanat 76 (Pt A):19272016

    • Search Google Scholar
    • Export Citation
  • 11

    Millesi HTerzis JK: Nomenclature in peripheral nerve surgery. Committee report of the International Society of Reconstructive Microsurgery. Clin Plast Surg 11:381984

    • Search Google Scholar
    • Export Citation
  • 12

    Onishi AOfford KDyck PJ: Studies to improve fixation of human nerves. 1. Effect of duration of glutaraldehyde fixation on peripheral nerve morphometry. J Neurol Sci 23:2232261974

    • Search Google Scholar
    • Export Citation
  • 13

    Pham M: [MR neurography for lesion localization in the peripheral nervous system. Why, when and how?] Nervenarzt 85:2212372014 (German)

    • Search Google Scholar
    • Export Citation
  • 14

    Romero-Ortega M: Peripheral nerves, anatomy and physiology of in Jaeger DJung R (eds): Encyclopedia of Computational Neuroscience. New York: Springer-Verlag2015

    • Search Google Scholar
    • Export Citation
  • 15

    Schmitt JMXiang SHYung KM: Speckle in optical coherence tomography. J Biomed Opt 4:951051999

  • 16

    Tian JChen LMa LYu W: Multi-focus image fusion using a bilateral gradient-based sharpness criterion. Opt Commun 284:80842011



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