中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2009年
2期
185-190
,共6页
刘记存%刘怀军%徐英进%贺丹%黄勃源%崔彩霞%王志红
劉記存%劉懷軍%徐英進%賀丹%黃勃源%崔綵霞%王誌紅
류기존%류부군%서영진%하단%황발원%최채하%왕지홍
脊髓损伤%磁共振成像%动物,实验
脊髓損傷%磁共振成像%動物,實驗
척수손상%자공진성상%동물,실험
Spinal cord injuries%Magnetic resonance imaging%Animal,laboratory
目的：研究脊髓持续受压性损伤模型的MR DTI动态演变规律。方法健康山羊18只，体重20～25 kg，采用完全随机设计分为A、B、C 3组，每组6只。手术显示左侧C3～4椎间孔，将自制的导管胶囊通过椎间孔向前、向上缓慢插入硬膜外腔，达C3～4椎间盘水平。 A、B组术后10 d时经导管向球囊内注入生理盐水，对脊髓进行压迫。 A组注水0．3 ml，B组注水0．2 ml，持续压迫40 d。C组为对照组，不注水。进行运动功能评分，行常规MRI和DTI检查，测量ADC值和各向异性分数（ FA）值。术后50 d 对受压脊髓进行光镜、电镜等病理学检查。对测量数据进行方差分析。结果3组动物术前运动功能评分均为5分，脊髓ADC值为（1．23±0．05）×10－3 mm2／s， FA 值为（0．72±0．05）。 A组6只羊脊髓受压后运动功能评分明显下降，40 d时为（1．5±0．4）分；ADC值先迅速降低，5 d时达最低值（0．75±0．04）×10－3 mm2／s，后逐渐回升，10 d左右恢复正常值，以后继续上升，40 d时显著高于正常，达（1．61±0．05）×10－3 mm2／s；FA值先迅速降低，1 d 时为0．54±0．04，以后继续缓慢降低，40 d时为0．43±0．05；压迫后10 d开始出现T2 WI高信号。 B组6只羊脊髓受压后运动功能评分轻度下降，40 d时为（3．4±0．5）分；ADC值先轻度降低，1 d 时为（1．08±0．04）×10－3 mm2／s，后逐渐回升，20 d左右恢复正常值，以后继续上升，40 d时轻度高于正常，为（1．27±0．05）×10－3 mm2／s；受压后FA值先轻度升高，1 d时为0．78±0．05，后逐渐下降，15 d左右恢复正常值，以后继续降低，40 d时轻度低于正常（0．67±0．05），常规MRI未见异常。 C组运动功能评分、ADC值、FA值与术前相同。 A、B组动物受压脊髓的ADC值、FA值均随时间而变化，A组变化幅度大于B组（重复测量数据方差分析，ADC值比较，F＝426．7，P＜0．01；FA值比较，F＝7895．2，P＜0．01）。A、B组的病理学改变为脊髓组织水肿、变性、坏死，白质内髓鞘板层状结构紊乱。 A组病理学改变较B组重。 C组病理学检查未见明显异常。结论持续压迫脊髓的ADC值和FA值随压迫持续时间的延长有动态变化，并与压迫程度有关系。 ADC值变化是降低、恢复正常、升高，较轻压迫FA值变化是升高、恢复正常、降低，较重压迫FA值变化是单纯降低。
目的：研究脊髓持續受壓性損傷模型的MR DTI動態縯變規律。方法健康山羊18隻，體重20～25 kg，採用完全隨機設計分為A、B、C 3組，每組6隻。手術顯示左側C3～4椎間孔，將自製的導管膠囊通過椎間孔嚮前、嚮上緩慢插入硬膜外腔，達C3～4椎間盤水平。 A、B組術後10 d時經導管嚮毬囊內註入生理鹽水，對脊髓進行壓迫。 A組註水0．3 ml，B組註水0．2 ml，持續壓迫40 d。C組為對照組，不註水。進行運動功能評分，行常規MRI和DTI檢查，測量ADC值和各嚮異性分數（ FA）值。術後50 d 對受壓脊髓進行光鏡、電鏡等病理學檢查。對測量數據進行方差分析。結果3組動物術前運動功能評分均為5分，脊髓ADC值為（1．23±0．05）×10－3 mm2／s， FA 值為（0．72±0．05）。 A組6隻羊脊髓受壓後運動功能評分明顯下降，40 d時為（1．5±0．4）分；ADC值先迅速降低，5 d時達最低值（0．75±0．04）×10－3 mm2／s，後逐漸迴升，10 d左右恢複正常值，以後繼續上升，40 d時顯著高于正常，達（1．61±0．05）×10－3 mm2／s；FA值先迅速降低，1 d 時為0．54±0．04，以後繼續緩慢降低，40 d時為0．43±0．05；壓迫後10 d開始齣現T2 WI高信號。 B組6隻羊脊髓受壓後運動功能評分輕度下降，40 d時為（3．4±0．5）分；ADC值先輕度降低，1 d 時為（1．08±0．04）×10－3 mm2／s，後逐漸迴升，20 d左右恢複正常值，以後繼續上升，40 d時輕度高于正常，為（1．27±0．05）×10－3 mm2／s；受壓後FA值先輕度升高，1 d時為0．78±0．05，後逐漸下降，15 d左右恢複正常值，以後繼續降低，40 d時輕度低于正常（0．67±0．05），常規MRI未見異常。 C組運動功能評分、ADC值、FA值與術前相同。 A、B組動物受壓脊髓的ADC值、FA值均隨時間而變化，A組變化幅度大于B組（重複測量數據方差分析，ADC值比較，F＝426．7，P＜0．01；FA值比較，F＝7895．2，P＜0．01）。A、B組的病理學改變為脊髓組織水腫、變性、壞死，白質內髓鞘闆層狀結構紊亂。 A組病理學改變較B組重。 C組病理學檢查未見明顯異常。結論持續壓迫脊髓的ADC值和FA值隨壓迫持續時間的延長有動態變化，併與壓迫程度有關繫。 ADC值變化是降低、恢複正常、升高，較輕壓迫FA值變化是升高、恢複正常、降低，較重壓迫FA值變化是單純降低。
목적：연구척수지속수압성손상모형적MR DTI동태연변규률。방법건강산양18지，체중20～25 kg，채용완전수궤설계분위A、B、C 3조，매조6지。수술현시좌측C3～4추간공，장자제적도관효낭통과추간공향전、향상완만삽입경막외강，체C3～4추간반수평。 A、B조술후10 d시경도관향구낭내주입생리염수，대척수진행압박。 A조주수0．3 ml，B조주수0．2 ml，지속압박40 d。C조위대조조，불주수。진행운동공능평분，행상규MRI화DTI검사，측량ADC치화각향이성분수（ FA）치。술후50 d 대수압척수진행광경、전경등병이학검사。대측량수거진행방차분석。결과3조동물술전운동공능평분균위5분，척수ADC치위（1．23±0．05）×10－3 mm2／s， FA 치위（0．72±0．05）。 A조6지양척수수압후운동공능평분명현하강，40 d시위（1．5±0．4）분；ADC치선신속강저，5 d시체최저치（0．75±0．04）×10－3 mm2／s，후축점회승，10 d좌우회복정상치，이후계속상승，40 d시현저고우정상，체（1．61±0．05）×10－3 mm2／s；FA치선신속강저，1 d 시위0．54±0．04，이후계속완만강저，40 d시위0．43±0．05；압박후10 d개시출현T2 WI고신호。 B조6지양척수수압후운동공능평분경도하강，40 d시위（3．4±0．5）분；ADC치선경도강저，1 d 시위（1．08±0．04）×10－3 mm2／s，후축점회승，20 d좌우회복정상치，이후계속상승，40 d시경도고우정상，위（1．27±0．05）×10－3 mm2／s；수압후FA치선경도승고，1 d시위0．78±0．05，후축점하강，15 d좌우회복정상치，이후계속강저，40 d시경도저우정상（0．67±0．05），상규MRI미견이상。 C조운동공능평분、ADC치、FA치여술전상동。 A、B조동물수압척수적ADC치、FA치균수시간이변화，A조변화폭도대우B조（중복측량수거방차분석，ADC치비교，F＝426．7，P＜0．01；FA치비교，F＝7895．2，P＜0．01）。A、B조적병이학개변위척수조직수종、변성、배사，백질내수초판층상결구문란。 A조병이학개변교B조중。 C조병이학검사미견명현이상。결론지속압박척수적ADC치화FA치수압박지속시간적연장유동태변화，병여압박정도유관계。 ADC치변화시강저、회복정상、승고，교경압박FA치변화시승고、회복정상、강저，교중압박FA치변화시단순강저。
Objective To explore the dynamic changes of diffusion tensor imaging( DTI) in spinal cord of goats with persistent compression injury.Methods Eighteen goats weighted 20—25 kg were divided into three groups with completely random design: A, B and C.A balloon catheter was inserted into the epidural space at C3—4 level via intervertabral foramen for each goat.The balloon was inflated by injection of variable volumes of saline in group A and B 10 days following operation.The volume of saline was 0.3 ml in group A and 0.2 ml in group B,respectively.The compression sustained for 40 days.Group C served as uncompressed control without injection of saline.The locomotor rating score was applied to each group. Conventional MRI and DTI were performed. The apparent diffusion coefficient ( ADC ) and fractional anisotropy(FA) values were measured.Histopathological assessments of the compressed spinal cord were performed 50 days following operation with light microscope and transmission electron microscopy.Results Before operation, the locomotor rating score was 5, the ADC value was (1.23 ±0.05) ×10 -3 mm2/s and the FA value was (0.72 ±0.05) each group.Of six goats in Group A, the locomotor rating score severely decreased and reached(1.5 ±0.4)on the 40 th day after compression.The ADC value at compression site decreased soon and reached the minimum (0.75 ±0.04) ×10 -3 mm2/s on the 5 th day after compression. Then the ADC value increased gradually, restored normal on the 10 th day or so, then became markedly higher than normal and reached(1.61 ±0.05) ×10 -3 mm2/s on the 40 th day.The FA value at compression site decreased soon, reached(0.54 ±0.04) on the 1st day, then decreased gradually and reached(0.43 ± 0.05) on the 40 th day.It appeared high signal intensity on T2 WI on the 10 th day.In Group B, the locomotor rating score was moderately decreased and reached(3.4 ±0.5)on the 40 th day.The ADC value at compression site decreased slightly firstly, reached(1.08 ±0.04) ×10 -3 mm2/s on the 1st day, restored normal on the 20 th day or so,then increased gradually, became higher than normal and reached(1.27 ± 0.05) ×10 -3 mm2/s on the 40 th day.The FA value increased slightly firstly, reached (0.78 ±0.05) on the 1st day, then decreased gradually, restored normal on the 15 th day or so,became lower than normal and reached(0.67 ±0.05) on the 40 th day.There was no abnormality on conventional MRI.In Group C, the locomotor rating score, ADC value and FA value remained unchanged. There was no abnormality on conventional MRI.There were dynamic changes over time of the ADC value and FA value in Group A and B, which was more marked in Group A than that in Group B(repeated measurements analysis of variance, F=426.7 for the ADC value and F=7895.2 for the FA value, P<0.01 ) .Histopathologically, swelling and degeneration of axons and neurons as well as the disarrangement of myelin sheathes could be seen.The pathological changes were more marked in Group A than in Group B.In Group C, no abnormality could be seen.Conclusion There are dynamic changes of DTI in cervical spinal cord with compressive injury that correlated with the degree and duration of compression.The ADC value decreased firstly, restored normal and then increased.The FA value increased firstly, restored normal and then decreased in mild compression while solely decreased in serious compression.
