颅脑爆震伤后兔脑内代谢变化的磁共振波谱研究  

Magnetic resonance spectroscopic study on regional cerebral metabolic changes of rabbits with explosive brain injury

作　　者：杨艳艳[1] 刘家传[1] 张永明[1] 孙文江[1] 汤宏[1] 黄振山[1] 李兵仓[2] 张良潮[2] 

机构地区：[1]安徽医科大学附属解放军第一0五医院神经外科,合肥230031 [2]第三军医大学附属大坪医院野战外科研究所,创伤、烧伤与复合伤国家重点实验室

出　　处：《中华创伤杂志》2011年第4期375-378,共4页Chinese Journal of Trauma

基　　金：基金项目：南京军区联勤部卫生部十一五重点基金资助项目（06219）

摘　　要：目的 利用磁共振波谱技术探讨颅脑爆震伤后不同时间段脑局部代谢变化.方法 新西兰大白兔45只采用随机数字表法分为对照组（10只）和创伤组（35只）,采用600 mgTNT当量纸雷管在创伤组兔脑上方约6.5 cm垂直距离爆炸,于伤后1,6,12,24 h、3,7,14 d用磁共振波谱技术观测动物存活情况,并检测脑损伤区病理及磁共振波谱表现,观察乙酰天门冬氨酸（N-acetylaspartate,NAA）/肌酸（creatine,Cr）、胆碱（choline,Cho）/Cr在爆震伤后随时间发展的演变过程.结果 创伤组兔存活时间在7 d以上,病理及常规MRI示脑挫伤病灶;NAA/Cr均值在损伤后1 h明显下降,持续至伤后24 h,24 h后义上升,7 d后再次下降.Cho/Cr均值在损伤1 h后即明显升高,12 h后下降,3 d后义逐渐升高.结论 磁共振波谱技术可反映兔颅脑爆炸伤不同时间段局部组织的代谢变化,为了解爆雀伤后局部组织变化情况及判断组织损伤类型提供理论依据.Objective To evaluate the regional cerebral metabolic changes in different episodes by magnetic resonance spectroscopy （MRS） after explosive brain injury in rabbits. Methods Fortyfive New Zealand white rabbits were randomly divided into eight groups, ie, normal control group（ 10 rabbits） and trauma group （35 rabbits）. The explosive injury in trauma group was induced by explosion of 600 mg TNT equivalent of paper detonators at 6.5 cm above the rabbit brain. The rabbits in trauma group was divided into 1,6, 12, 24 hours, 3, 7, 14 days subgroups （6 rabbits per group）. The survival rate was observed at different time points after explosive injury. The MRS was used to detect the regional cerebral metabolic changes including N-acetylaspartate （NAA）/creatine （Cr） ratio and choline（Cho）/Cr ratio as well as evolution of blast injuries over time. Results The rabbits survived for overseven days in the trauma groups, with typical brain contusion manifested by pathological and conventional MRI. Compared with the normal control group, the NAA/Cr ratio was markedly decreased at one hour after injury, slightly rose again at 24 hours and fell again after seven days. The Cho/Cr ratio was markedly increased at one hour after injury, slightly fell again at 12 hours and rose again at three days after injury.Conclusions MRS can manifest the regional cerebral metabolic changes of rabbits with explosive injury at different time points and hence provide a theoretical basis for understanding the local tissue changes and determining the type of tissue damage after blast injury.

关 键 词：脑损伤 爆震伤 波谱分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]