一氧化氮供体介入给药抗缺血性脑损害的弥散加权成像及灌注加权成像评价  

Evaluation of Imaging on the Cerebral Ischemia/reperfusion with the Intervention of NO Donor

作　　者：周佩洋 高平 朴翔宇 

机构地区：[1]襄阳市第一人民医院,湖北襄阳441000 [2]辽宁省脑疾病研究所,辽宁大连116001

出　　处：《医学综述》2011年第19期3009-3011,3017,共4页Medical Recapitulate

摘　　要：目的通过影像学探讨脑缺血早期一氧化氮供体对脑损伤的保护作用。方法制作小型猪脑缺血模型,于阻断后立即介入给予硝酸甘油。阻断前、阻断期、再灌注后0.5 h、2 h分别给予影像学评价。结果阻断期脑血管造影可见双侧咽升动脉及其分支血管血流阻断,再灌后0.5 h和2 h双侧咽升动脉及其分支血管血供恢复;弥散加权成像显示在缺血/再灌注后各时间点给药侧表观弥散系数较对侧明显升高,差异具统计学意义(P<0.05)。灌注加权成像显示阻断期局部脑血流与阻断前比较显著下降(P<0.01),达峰时间延迟。T1和T2加权像在阻断前、阻断期和再灌后各时间点均未发现异常信号。结论脑缺血早期一氧化氮供体局部介入给药具有脑保护作用。Objective Using the functional and morphological magnetic resonance imaging（MRI） to validate whether NO donor had the protection effects on brain injury in an ischemia piglet model with the intervention of Nitroglycerin in acute ischemic stage.Methods Bilateral ascending pharyngeal arteries were blocked with air bladders in piglets.Left ascending pharyngeal artery was intervened with Nitroglycerin immediately after blocking,MRI was performed at 1.5T n piglets,apparent diffusion coefficient（ADC）,relative cerebral blood flow（rCBF）,and time-to-peak（TTP） contrast were estimated at different time points before,during,and after blocking（0.5h,2h）.The effect following bilateral blocking ascending pharyngeal arteries was appraised by DSA.Results Blood flow of bilateral ascending pharyngeal arteries and arborization was blocked completely during-blocking,and it normalized at any time after reperfusion.ADC was significantly stepped up at any time point after perfusion on the intervention side（P0.05）.There was a significant reduction in rCBF during blocking compared to pre-blocking time points（P0.01）,there was no significant reduction in rCBF of both sides compared to pre-blocking time points.There was no abnormal signal in the T1-weighted and T2-weighted at any of the time points investigated.Conclusion It may be concluded that NO donor has the protection effects on brain injury in acute ischemic stage.

关 键 词：弥散加权成像 灌注加权成像 脑缺血 硝酸甘油 小型猪 

分 类 号：R743.33[医药卫生—神经病学与精神病学]