CAJ | 학술논문

目的：制作兔坐骨神经急性牵拉伤可逆损伤模型，探讨纤维示踪成像（DTT）评价坐骨神经急性牵拉伤的可行性及准确性。方法：选取32只新西兰白兔，牵拉右侧坐骨神经建立退变与修复模型；左后肢为假手术侧。于术后1、3 d及1、2、3、4、6、8周行MR扩散张量成像并行纤维示综，测量神经纤维束长度及平均神经纤维密度指数。MRI检查完毕，于各时间点取1只兔坐骨神经行病理检查。结果：坐骨神经牵拉伤术后1 d～2周损伤侧纤维束长度与假手术侧有明显差异（P＜0．05）；3～8周损伤侧坐骨神经纤维束长度与假手术侧无明显差异。术后1 d～8周损伤侧平均神经纤维密度指数与假手术侧有明显统计学差异（P＜0．05）；牵拉伤后1 d牵拉段可见较多髓鞘扭曲，3 d牵拉段轴索明显崩解。2周神经退变与再生并存，8周神经纤维再生基本成熟。结论：神经纤维束长度及平均神经纤维密度指数～时间曲线与病理学的变化趋势相一致，可作为评价神经损伤退变及再生的补充手段。
목적：제작토좌골신경급성견랍상가역손상모형，탐토섬유시종성상（DTT）평개좌골신경급성견랍상적가행성급준학성。방법：선취32지신서란백토，견랍우측좌골신경건립퇴변여수복모형；좌후지위가수술측。우술후1、3 d급1、2、3、4、6、8주행MR확산장량성상병행섬유시종，측량신경섬유속장도급평균신경섬유밀도지수。MRI검사완필，우각시간점취1지토좌골신경행병리검사。결과：좌골신경견랍상술후1 d～2주손상측섬유속장도여가수술측유명현차이（P＜0．05）；3～8주손상측좌골신경섬유속장도여가수술측무명현차이。술후1 d～8주손상측평균신경섬유밀도지수여가수술측유명현통계학차이（P＜0．05）；견랍상후1 d견랍단가견교다수초뉴곡，3 d견랍단축색명현붕해。2주신경퇴변여재생병존，8주신경섬유재생기본성숙。결론：신경섬유속장도급평균신경섬유밀도지수～시간곡선여병이학적변화추세상일치，가작위평개신경손상퇴변급재생적보충수단。
Objective To make sciatic nerve traction injury models of rabbit , in order to prospectively evaluate possibility and accuracy of diffusion tensor tracking (DTT) in sciatic nerve injures. Methods The right sciatic nerves of 32 New Zealand white rabbits were selected for traction injury , and the left sciatic nerves were the sham operation side. DTI scan was performed before and after the operation on 1st day , 3rd day, and 1 week, 2, 3, 4, 6 and 8th week respectively, and DTT was reconstructed. Then the length of reconstructed fiber tracts and fiber density index were calculated. After the MRI scan , the sciatic nerve was removed to perform pathologic examination at different time points. Results The difference of the length of reconstructed fiber tracts between nerve traction injury and sham operation side was significant at 1 day~2weeks after operation (P<0.05), while the difference was not significant at 3~8 weeks.The fiber density index of nerve traction injury and sham operation side was significantly different at 1 day~8 weeks(P<0.05). 1day after operation, myelin sheath of traction portion was obviously twisting. 3 days after operation , a large amount of myelin sheath broke down. 2 weeks after operation , axon, myelin sheath degeneration and regeneration coexisted at the same time. 8 weeks after operation , nerve fibers regenerated and restored to normal structure. Conclusion The length time curve and density index-time curve of nerve traction injury are consistent with the changes of pathology , which can be used as a supplementary method to evaluate the degeneration and regeneration in nerve injury.