急性脑静脉闭塞模型的CT灌注成像与病理学评价  

Evaluation of Acute Experimental Cerebral Venous Occlusion with CT Perfusion Imaging and Histopathology

作　　者：郭大静[1] 孔祥泉[1] 王志刚[2] 赵建农[3] 陈维福[4] 倪卫国[3] 敬永勇[3] 

机构地区：[1]武汉华中科技大学同济医学院附属协和医院放射科,430022 [2]重庆医科大学附属第二医院超声影像研究所,400010 [3]重庆医科大学附属第二医院放射科,400010 [4]重庆医科大学附属第二医院脑外科,400010

出　　处：《临床放射学杂志》2005年第12期1103-1106,共4页Journal of Clinical Radiology

摘　　要：目的用CT灌注成像(CTPI)和病理学方法对急性脑静脉闭塞动物模型进行评价. 材料与方法家猫22只,随机分为2组(手术组18只,假手术组4只).手术组采用开颅上矢状窦穿刺注射液体栓塞剂--醋酸纤维素聚合物(CAP)制备急性脑静脉闭塞动物模型,术后1、3、6、12、24、48 h用CTPI对各组模型的脑血流动力学改变进行观察,其结果和病理学对照研究.假手术组只做钻孔颅骨开窗暴露上矢状窦,但不进一步操作. 结果手术组12只猫CTPI出现脑血流异常灌注区.术后1 h,病变表现为局部脑血容量(rCBV)轻度增加,局部脑血流量(rCBF)轻度降低,平均通过时间(MTT)稍延长;3～6 h后病变中心区主要表现为 rCBV和rCBF降低,而病变边缘区rCBV增加或正常或轻度降低,rCBF降低;12～24 h后病变中心区和边缘区rCBV和rCBF均明显降低.大体病理学检查上矢状窦、桥静脉及皮层静脉内见CAP凝固呈铸型改变,3 h后病变区见伊文思蓝不同程度蓝染.显微病理学检查10只猫出现脑实质损害,病变以血管源性水肿为主,12 h后出现出血性脑梗死.假手术组4只猫均未见上述各种异常表现. 结论功能CT灌注成像是评价急性脑静脉闭塞模型血流动力学改变的一种准确、敏感的方法,可早期评价脑实质损害的程度.Objective To evaluate model of acute cerebral venous occlusion with CT perfusion imaging（CTPI） and histopathological. Materials and Methods 22 cats were randomly divided into 2 groups, including operation group （ n = 18） and control group （n = 4）. Acute cerebral venous occlusion were induced by injection of the cellulose acetate polymer （CAP） solution into the superior sagittal sinus （SSS）. CTPI were performed at an interval of i, 3, 6, 12, 24 and 48h after operation. The hemodynamie changes were observed in each group, the CTPI data were compared with pathological findings. Results Abnormal cerebral blood flow perfusion areas were detected in 12 cats in operation group by CTPI. Regional cerebral blood volume（rCBV）increased, regional cerebral blood flow（rCBF）decreased and mean transit time（ MTT）prolonged slightly in the lesions after l h. Both rCBV and rCBF decreased in the center of the lesions, while rCBV increased, normal or decreased, rCBF decreased in the marginal zone after 3 ～6h, rCBV and rCBF decreased obviously both in the center and marginal zone after 12h～24h, There were eastlike materials formed by CAP within SSS, bridging veins and cortical veins, The cortical lesions were stained with Evans blue dye alter 3h, Brain parenchymal damage lesions were found in 10 cats microscopically, the lesions were mainly vasogenie edema and followed by necrosis with venous hemorrhagic infarction after 12 hours, No abnormal changes were observed in control group, Conclusion CT perfusion imaging is accurate and sensitive in evaluating hemodynamies of acute cerebral venous occlusion and is useful in the early evaluation of the consequences for brain parenchymal lesions.

关 键 词：疾病模型 动物 脑静脉闭塞 体层摄影术 X线计算机 

分 类 号：R743[医药卫生—神经病学与精神病学]