犬急性脑栓塞模型的建立及CT灌注成像早期诊断的研究  

Interventional model establishment and computed tomography perfusion imaging for early diagnosis of acute cerebral infarction in dogs

作　　者：施海彬[1] 刘圣[1] 季立标[1] 李麟荪[1] 黄峻[2] 

机构地区：[1]南京医科大学第一附属医院放射科,210029 [2]南京医科大学第一附属医院心血管内科,210029

出　　处：《介入放射学杂志》2005年第2期182-186,共5页Journal of Interventional Radiology

基　　金：江苏省医学重点人才工程项目 ( 13 5 5 5 );江苏省教育厅自然科学研究项目 ( 0 2KG0 3 2 0 0 0 5 )

摘　　要：目的　用介入技术建立一种能用于影像学诊断与溶栓治疗研究的犬急性脑栓塞动物模型 ,并探讨CT灌注成像技术 (CTP)对脑缺血超急性期诊断的应用价值。方法　 10只成年毕格犬 ,抽取犬自体静脉血制作白色血栓。透视下将 4F猎人头导管插至左侧颈内动脉注入血栓 ,分别在栓塞前以及栓塞后即时和 1、2、5h行脑血管造影观察所栓塞血管的通畅情况 ,同时在栓塞后 2h行CTP检查。 2 4h处死动物后取脑组织进行病理检查。结果　 10只犬左侧大脑中动脉全部栓塞成功 ,其中 4只犬合并其他脑血管栓塞 ,至栓塞后 2h造影显示所有被栓塞血管未发生再通 ,5h造影发现 2只犬的栓塞血管出现部分再通。CTP检查发现 9只犬患侧脑局部血流量平均减少为对侧的 4 8.3%± 0 .132 % (33.7%～6 9 .2 % )。CTP与数字减影血管造影诊断比较没有明显的统计学差异 (P >0 .0 5 )。 2 4h后动物均存活 ,未出现严重并发症 ,病理检查证实在深部脑组织皆出现脑梗死病灶。结论　介入栓塞技术建立的犬急性脑栓塞动物模型具有操作简单、创伤小、易存活、栓塞可靠的优点 ,可用于脑梗死的早期诊断及溶栓治疗研究 ;CTP检查可快速、准确。Objective To establish interventionally a new canine model of focal cerebral infarction suitable to the study of imaging diagnosis and thrombolytic therapy, and to evaluate the application of computed tomography perfusion (CTP) in super acute ischemic cerebrovascular disease. Methods Ten beagle adult dogs with self white thrombi of venous blood, injected into the left internal carotid arteries through 4F headhunter catheter selectively were created under fluoroscopic guidance. The cerebral angiography was performed before and after the embolization and the patency of the occluded cerebral arteries was observed with angiography at 1, 2 and 5 hours after the procedure. The CTP was performed at 2 hours after embolization. These dogs were sacrificed and their cerebri were taken out for pathologic study at 24th hour. Results The occlusions of middle cerebral artery were shown angiographically in all 10 dogs with additional other cerebral arteries occlusion in 4. All occluded arteries were not recanalized at 2 hours after embolization, but the occluded arteries of 2 canines were partly recanalized at 5 hours. The regional cerebral blood flow (rCBF) was decreased to 48.3%±13.2% (33.7%～69.2%) in CTP of 9 canines showing no significant difference between digital subtraction angiography (DSA) and CTP (P>0.05). All dogs were survived at 24 hours without any severe complications. The cerebral infarction was found in deep part of cerebrum of all dogs. Conclusions The establishment of acute cerebral infarction model in dogs with interventional technique is simple, microinvasive and reliable, for investigating CTP as a fast, accurate and no invasive method in evaluating the canine super acute ischemic cerebrovascular disease.

关 键 词：急性脑栓塞 早期诊断 CT灌注成像技术 数字减影血管造影 血流动力学变化 局部脑缺血模型 颈内动脉注入 脑局部血流量 介入栓塞技术 动物模型 溶栓治疗 病理检查 影像学诊断 自体静脉血 脑血管造影 大脑中动脉 脑血管栓塞 

分 类 号：R816.1[医药卫生—放射医学]