大鼠骨骼肌急性挤压伤冰敷治疗扩散张量成像动态研究  

Acute crush injuries of skeletal muscle of mice with ice-compression therapy： a dynamic study with diffusion tensor imaging

作　　者：王丰哲[1] 潘诗农[1] 安琦[2] 舒红[3] 李琦[1] 孙鹤[1] 张光昕[1] 郭启勇[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004 [2]沈阳市第四人民医院放射科 [3]中国医科大学附属盛京医院病理科,沈阳110004

出　　处：《中华放射学杂志》2010年第12期1329-1334,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金资助项目（30871211）;辽宁省教育厅科学研究计划项目（2009T098）

摘　　要：目的 评估DTI技术在大鼠骨骼肌急性挤压伤的诊断及不同冰敷时间对骨骼肌损伤治疗效果评价中的价值.方法 将40只Weistar大鼠采用随机数字表方法均分成4组：正常组（A组）、5 min冰敷组（B组）、15 min冰敷组（C组）和30 min冰敷组（D组）,模拟骨骼肌挤压伤及冰敷模型,分别于损伤前、损伤后冰敷即刻、24 h、48 h、72 h对各组进行MR DTI扫描,测量ADC值与各向异性（FA）值.损伤标本进行常规HE染色及SABC（链霉亲和素-生物素复合物）法结蛋白（Desmin）染色,测量平均吸光度（A）值.两组均数间的两两比较采用LSD-t检验,对DTI测量结果与Desmin阳性表达A值进行Spearman秩相关分析.结果 （1）各组大鼠损伤前（n=10）即正常骨骼肌ADC值分别为（1.38±0.04）×10-3、（1.38±0.08）×10-3、（1.34±0.05）×10-3、（1.36±0.09）×10-3mm2/s,FA值分别为0.46±0.05、0.45±0.03、0.45±0.05、0.48±0.04.损伤后即刻（n=8）各组ADC值较损伤前明显增加,FA值明显减小,ADC值分别为（1.84±0.10）×10-3、（1.79±0.09）×10-3、（1.55±0.07）×10-3、（1.57±0.04）×10-3mm2/s,FA值分别为0.21±0.04、0.26±0.03、0.31±0.02、0.30±0.04.损伤后24 h（n=6）时A、B组的ADC值依然较损伤前增高,FA值减小,ADC值分别为（1.54±0.13）×10-3、（1.57±0.13）×10-3mm2/s,FA值分别为0.25±0.03、0.26±0.02.（2）DTT（白质纤维束成像）显示损伤后即刻各组纤维走行扭曲,纤维束数量明显减少,部分分离、移位,C、D组较A、B组减轻,随时间逐渐好转.（3）HE染色显示骨骼肌损伤后肌细胞水肿,肌纤维分离、断裂,但C、D组水肿较A、B组减轻.骨骼肌损伤后即刻及24 h,Desmin染色变淡,边缘缺失、模糊.72 h后Desmin染色重新增加.（4）ADC值、FA值与A值均具有相关性（r值分别为-0.789、0.763,P值均＜0.05）.结论 DTI能够无创性定量反映大鼠骨骼肌急性挤压伤及冰敷后的病理过程,有助于指导、评价�Objective To evaluate the value of ice-compression therapy in mice skeletal muscle after acute crush injuries and correlate treatment effect with different compression time by MR DTI. Methods Forty Weistar mice were randomly divided into 4 groups by random number table method： control group （A）, 5 min compression time group（ B）, 15 min compression time group（C） and 30 min compression time group（D）. Diffusion tensor imaging examinations were performed before, immediately after, 24, 48 and 72 hours after injuries. ADC and FA values were calculated by fiber tracking tool. The morphological changes were confirmed by histopathology, and immunohistochemical methods were used for the assessment of Desmin expression with mean of A value. Statistical analysis by LSD-t test and Spearman rank correlation.Results （1） For every group before injuries, ADC valueswere （1.38±0.04） ×10-3,（1.38±0.08） ×10-3, （ 1.34 ± 0. 05 ） × 10 -3, （ 1.36 ± 0. 09 ） × 10 -3 mm2/s respectively, FA value were 0. 46 ± 0. 05,0. 45 ±0. 03,0. 45 ± 0. 05,0. 48 ± 0. 04 respectively. ADC values increased significantly and FA values reduced in each group immediately after injuries compared with pre-injury values. ADC values were （ 1.84 ±0. 10） × 10-3, （ 1.79 ±0. 09） × 10-3, （ 1.55 ±0. 07） × 10-3, （ 1.57 ±0. 04） × 10 -3mm2/s respectively,FA value were 0. 21 ±0. 04, 0. 26 ±0. 03, 0. 31 ±0. 02, 0. 30 ±0. 04 respectively. ADC values were still higher and FA values lower than pre-injury values at 24 hours after injury in A, B groups. ADC values were （1.54±0.13） ×10-3, （1.57±0.13） × 10-3mm2/s, FA value were 0.25 ±0.03, 0.26±0.02. （2）DTT showed fibers distorted and the number of fiber bundles reduced, some separation and displacement in each group immediately after injury. C, D groups improved more than A, B groups over time. （3） The disorder arrangement of skeletal muscle cells with edema and filaments separation were found in HE staining after injury, but the degre

关 键 词：肌 骨骼 磁共振成像 

分 类 号：R686[医药卫生—骨科学]