结扎兔颈静脉对脑血流灌注的影响  

Influences on the cerebral blood perfusion by ligation of the rabbit jugular vein: assessment with MR perfusion imaging

作　　者：刘奉立[1] 丛振杰 于本霞[1] 于国平[1] 董建军[1] 高波[1] 宋喜顺[1] 邹萍[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院影像中心,山东烟台264000 [2]烟台肿瘤职业病医院,山东烟台264000

出　　处：《医学影像学杂志》2009年第11期1477-1481,共5页Journal of Medical Imaging

基　　金：烟台市科技发展计划项目(编号:2008142-6)

摘　　要：目的:探讨结扎兔颈总静脉对脑血流灌注的影响。方法:选择健康成年家兔24只,随机分成A、B两组。A组(12只)先结扎一侧颈总静脉,24h后再结扎另一侧颈总静脉;B组(12只)则同时结扎双侧颈总静脉。磁共振血流灌注成像(PWI)采用美国通用电气公司生产的EXCITE 3.0T成像仪,于结扎颈静脉前和结扎后0.5h、6h、24h分别做脑血流灌注成像。同时进行脑部普通MR成像、弥散加权成像(DWI)、TOF法血管成像和动态增强血管成像(DCE-MRA),观察脑组织信号改变和颅颈部血管血流情况,2例加做了颈部血管PC法血流速度测定。结果:单侧颈静脉结扎和双侧颈静脉结扎后,MSD、TTM、NEI和MTE各参数均值均较对照值增大,以0.5h和6h时间点变化最明显,差别有极显著统计学意义(P<0.01)。但在单侧结扎基础上再行双侧颈静脉结扎时NEI的变化则不再显著。单侧颈静脉结扎和双侧颈静脉结扎的组间比较,在结扎后0.5h MSD和NEI出现了有显著统计学意义的差别(P<0.05),但在6h和24h时间点,两组间各参数差别无显著意义。以各测量时间点为依据进行分组,用F检验法对原始数据做组间的两两比较,其统计结果与配对资料的t检验有较好的一致性。结论:在使用相同设备、相同检查方法的前提下,磁共振血流灌注成像可用于评价同一个体不同时间,或一群个体不同时间的脑血流灌注变化。脑静脉回流受阻主要引起脑的血流灌注时间延长和过度灌注状态,在家兔这种高灌注状态一般在24h后即可通过代偿机制自行恢复。Objective： To investigate the cerebral blood peffusion changes after ligation of rabbit jugular vein by means of MR peffusion imaging. Methods：24 adult rabbits were divided randomly into two groups. In group A （12 rabbits）, one jugular vein was ligated first, with another jugular vein ligated 24 hours later. In group B （ 12 rabbits）, the two jugular veins were ligated simultaneously. MR peffusian imaging of the brain was performed before the ligation as a control, and 0.5-, 6-, 24-hotrrs after the ligafion （GE excite 3.0T equip- ment）. Routine MILI, DWI, TOF-M1LA, DCE-MRA were performed to inspect the changes of brain signal intensity and craniocervical blood vessels. In two animals, phase-contrast flow analysis of cervical blood vessels was performed.Results：MSD, TI＇M, NEI and MSD turned to larger after unilateral as well as bilateral llgation of the jugular vein, especially at the time points of 0.5 h and 6 h. The change was statistically significant （ P 〈 0.01）. But, for the consequent ligation of the contralateral jugular vein, NEI did not change signitl- candy. As for the inter-group comparison, MSD and NEI showed a significant difference （ P 〈0.05） at the time point of 0.5 h, but no significant difference at the time points of 6 h and 24 h. In time-point based analysis, the primitive data were compared by F test, which showed a consistent result with the paired-t test. Conclusion： MR perfusion weighted imaging can be used to asse~ the event-related cere- bral blood perfusion changes provided that the same equipment and the same imaging method are used. Obstructed venous drainage causes prolonged cerebral blood peffusion and hyperperfasion. In rabbit, the hyperperfusion state will relieve by the autoregulation mechanisms in 24 hours.

关 键 词：脑血流灌注成像 磁共振成像 颈静脉结扎 脑静脉回流受阻 高灌注状态 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]