CAJ | 학술논문

目的：探讨大鼠脑挫伤(TBI)后非损伤侧脑组织表观扩散系数(ADC )变化及其病理改变。方法选健康成年 Wistar 大鼠60只,制作中度脑挫伤模型,随机分为对照组及创伤组(1 h、3 h、6 h、12 h 及24 h 组),每组各10只,各时相点分别进行头部 MR-DWI 检查,测量损伤侧与镜像非损伤侧区的 ADC 值,取脑进行组织学观察、IgG 免疫组化染色半定量观察血脑屏障(BBB)的通透性,所得值进行统计学分析。结果对照组双侧脑组织结构及 DWI 未见异常,IgG 染色阴性。创伤组非损伤侧1 h 脑组织结构及DWI 未见异常,IgG 染色阴性。3 h 出现细胞内水肿,IgG 染色弱阳性。6 h 细胞内水肿加重,同时出现血管源性水肿,IgG 染色呈强阳性。12~24 h 细胞内水肿仍继续加重,而血管源性水肿有缓解趋势,IgG 染色减弱,并见小胶质细胞增生。非损伤侧 ADC 值与对照组比较差异无统计学意义(P >0.05)。损伤侧脑组织在1 h 即出现血管源性水肿,3 h 出现细胞内水肿,随时间2种水肿逐渐加重。ADC 值在1 h 升高、然后开始降低至6 h,6 h 后开始回升直至24 h,呈现“V”形变化趋势。结论当一侧脑挫伤时,非损伤侧的脑组织有相应的病理变化,在时间上滞后于损伤侧,首先出现的是细胞内水肿,然后发生血管源性水肿,随损伤时间延长血管源性水肿有缓解趋势,但 ADC 值无显著变化,呈现“假性正常”现象。
목적：탐토대서뇌좌상(TBI)후비손상측뇌조직표관확산계수(ADC )변화급기병리개변。방법선건강성년 Wistar 대서60지,제작중도뇌좌상모형,수궤분위대조조급창상조(1 h、3 h、6 h、12 h 급24 h 조),매조각10지,각시상점분별진행두부 MR-DWI 검사,측량손상측여경상비손상측구적 ADC 치,취뇌진행조직학관찰、IgG 면역조화염색반정량관찰혈뇌병장(BBB)적통투성,소득치진행통계학분석。결과대조조쌍측뇌조직결구급 DWI 미견이상,IgG 염색음성。창상조비손상측1 h 뇌조직결구급DWI 미견이상,IgG 염색음성。3 h 출현세포내수종,IgG 염색약양성。6 h 세포내수종가중,동시출현혈관원성수종,IgG 염색정강양성。12~24 h 세포내수종잉계속가중,이혈관원성수종유완해추세,IgG 염색감약,병견소효질세포증생。비손상측 ADC 치여대조조비교차이무통계학의의(P >0.05)。손상측뇌조직재1 h 즉출현혈관원성수종,3 h 출현세포내수종,수시간2충수종축점가중。ADC 치재1 h 승고、연후개시강저지6 h,6 h 후개시회승직지24 h,정현“V”형변화추세。결론당일측뇌좌상시,비손상측적뇌조직유상응적병리변화,재시간상체후우손상측,수선출현적시세포내수종,연후발생혈관원성수종,수손상시간연장혈관원성수종유완해추세,단 ADC 치무현저변화,정현“가성정상”현상。
Objective This study was designed to investigate the correlation between the apparent diffusion coefficient(ADC)value and pathological change of the non-injured side brain tissue of traumatic brain injury(TBI)of rat.Methods Sixty healthy adult Wist-ar rats were randomly divided into two groups:the control or TBI groups.The TBI group was divided into five sub-groups according to the different time intervals:1,3,6,12,24 h(n = 10).The animal brain of each group was scanned with MR-DWI,and the ADC value of damaged areas and contralateral non-damaged areas were measured.After that the brains were taken out at different time points after TBI.The cerebral edema and blood-brain barrier(BBB)changes in structure were examined with an optical micros-copy and transmission electron microscopy,and the IgG content in the same tissues were determined by means of immunohistochem-istry.The data was analyzed with SPSS 13.0 statistical software.Results There was no signal abnormality on MR-DWI and tissue structure in control group,and the IgG stain was negative.In the contralateral non-damaged areas of TBI group,pathological obser-vation revealed no variation at 1 h after TBI,and the IgG stain was also negative.Cellular edema was shown at 3 h and the IgG stain was slight positive.The cellular edema aggravated with time and angioedema appeared at 6 h.IgG stain was shown significantly posi-tive.At 12~24 h,cellular edema kept increasing more severe,however angioedema had a trend to mitigated along with time,IgG stain became slight and the proliferation of glial cells could observed.Compared with control group,the ADC values of the contralat-eral non-damaged areas in each group showed no significant difference (P >0.05).However,in the damaged areas of each group, angioedema appeared at 1 h and gradually aggravated,cellular edema occurred at 3 h,Both of them were aggravated with time. ADC values increased at 1 h,and then decreased until 6 h,then followed a climbing up to 24 h,showed as a “V”-shaped.Con-clusion When contused on one side brain,the contralateral non-inj ured side tissue also has pathological changes that occurs later than those on the inj ured side.Cellular edema of the tissues ap-peares first and is followed by angioedema,which lessens over time..There is no significant difference of ADC values between con-tralateral side of TBI groups and control group(P >0.05),which reveals a “pseudo-normal”phenomenon.