多层螺旋CT灌注成像对肺栓塞再灌注损伤的实验研究  

Experimental study of multi-slice spiral CT perfusion imaging for pulmonary embolism-reperfusion injury

作　　者：包娜[1] 翟仁友[1] 王辰[2] 蒋涛[1] 郑娟[1] 金文辉[1] 

机构地区：[1]首都医科大学附属朝阳医院放射科,北京100020 [2]首都医科大学附属朝阳医院呼吸科,北京100020

出　　处：《中国医学影像技术》2006年第6期811-815,共5页Chinese Journal of Medical Imaging Technology

基　　金：首都医学发展基金资助项目(20031017)

摘　　要：目的应用CT灌注成像技术量化评价肺栓塞再灌注损伤,探讨肺栓塞再灌注损伤形成机制。方法选择14只健康杂种犬为实验对象。利用SwanGanz导管模拟肺膈叶动脉栓塞再灌注。栓塞前、栓塞24h和再通4h要分别进行肺动脉压测定、CT灌注成像和血清超氧化物歧化酶(SOD)的测定。结果再灌注肺损伤主要表现为急性渗透性肺水肿。再灌注损伤肺的BF[(325.69±134.00)ml·min-1·100g-1)]和MTT[(1.98±0.44)s]与栓塞前正常基线值[(409.58±88.42)ml·min-1·100g-1)和(1.87±0.48)s]的差异具有统计学意义(P<0.01和P<0.05)。再灌注4h的肺动脉压[(25.79±6.25)mmHg]和超氧化物歧化酶的平均值[(388.79±25.07)U/ml]与栓塞前正常基线值[(22.31±3.77)mmHg和(404.38±23.81)U/ml]相比均具有统计学差异(P<0.05和P<0.05)。再灌注损伤侧肺的湿/干重比率(6.29±1.23)显著大于对侧肺(4.54±1.19),其差异也具有统计学意义(P<0.01),说明再灌注水肿增加了肺组织的含水量。结论CT灌注成像有效反映肺栓塞再灌注损伤的血流动力学改变。氧自由基对肺栓塞再灌注损伤的形成起重要作用。Objective To assess pulmonary embolism-reperfusion injury in quantitative multi-slice CT perfusion imaging and to explore the mechanisms of pulmonary embolism-reperfusion injury. Methods Experiments were made on 14 healthy canines. With the use of a Swan-Ganz catheter, pulmonary embolism-reperfusion maneuvers were done at diaphragmatic lobe arteries. Pulmonary artery pressure （PAP）, CT perfusion imaging and superoxide disrnutase （SOD） were undertaken at normal condition, at 24 h PE and at 4 h reperfusion. Results Reperfusion pulmonary injury was generally characterized by acute permeability edema. The mean of BF and MTT of the injured lung was （325.69±134.00） ml·min^-1 ·100 g^-1 and （1.98±0. 44） s, which was significantly different （P〈0. 01 and P〈0.05） from normal base-line level [（409.58±88. 42） ml · min^-1 100 g^-1） and （1.87±0.48） s]. The mean of PAP and SOD of 4 h reperfusion injury was （25.79±6.25） mmHg and （388.79±25.07） U/ml, which was significantly different （P〈0. 05 and P〈0.05） from normal base-line level [（22.31±3.77） mmHg and （404.38±23.81） U/ml]. The mean wet/dry weight ratio of the injured lung of （6.29±1.23） was significantly greater（P〈0. 01） than the mean value of （4.54±1.19） of the contralateral lung, suggesting that the increase in the lung water was due to reperfusion edema. Conclusion Multi-slice CT perfusion imaging may play an increasing role to delineate the depiction of pulmonary hemodynamics in pulmonary embolism-reperfusion injury. O2 free radicals is a key factor in the pulmonary embolism-reperfusion injury.

关 键 词：肺栓塞 再灌注损伤 多层CT灌注成像 氧自由基 

分 类 号：R563.5[医药卫生—呼吸系统] R814.42[医药卫生—内科学]