CT灌注结合醋甲唑胺负荷试验对32周龄原发性高血压大鼠脑血管储备功能的初步研究  

Preliminary study on cerebrovascular reserve capacity of 32-week-old spontaneous hypertensive rat by CT perfusion combined with methazolamide stress test

作　　者：王欣全[1] 顾红梅[1] 李敏[1] 陆德明[1] 汤凯燕 周国锋[1] 李敏达[1] 

机构地区：[1]南通大学附属医院影像科,南通226001

出　　处：《南通大学学报（医学版）》2014年第1期19-22,共4页Journal of Nantong University(Medical sciences)

摘　　要：目的：探讨CT灌注结合醋甲唑胺负荷试验评估原发性高血压大鼠（spontaneous hypertensive rat，SHR）脑血管储备功能变化的可行性，并与病理实验结果对照，评价其对亚临床期脑缺血患者的临床应用价值。方法：正常对照组、SHR组各10只行常规脑CT灌注扫描及醋甲唑胺灌胃后1.5~2.0 h脑CT灌注扫描，测量负荷前后感兴趣区脑血容量（cerebral blood volume，CBV）、脑血流量（cerebral blood flow，CBF）、平均通过时间（mean transit time，MTT）及达峰时间（time to peak，TTP）值，并作统计学分析；光镜下观察大鼠脑石蜡HE染色切片小动脉管壁厚度、微循环毛细血管网情况，通过TTC染色明确各组大鼠脑组织有无脑梗死灶。结果：CT灌注扫描：两组大鼠负荷前后自身比较，正常组CBV、CBF、MTT、TTP值差异均有统计学意义（P＆lt;0.05），且负荷状态下CBV、CBF值增加，MTT、TTP值缩短；SHR组差异均无统计学意义。组间比较，两组大鼠负荷前后CBV、CBF、MTT、TTP值差异均有统计学意义（P＆lt;0.05），且SHR大鼠CBV、CBF值减低，MTT、TTP值延长。 HE染色示SHR组小动脉及微小动脉管壁重塑，管壁增厚、硬化，微循环毛细血管网数目相对减少。TTC染色示SHR大鼠脑组织无明确脑梗死灶。结论：SHR较正常大鼠脑血管储备减低，醋甲唑胺负荷CT灌注成像可反映脑血管储备功能改变，对亚临床期脑缺血患者的病情评估具有重要临床指导意义。Ob jective： To explore the feasibility of perfusion CT combined with methazolamide stress test in evaluating the changes of the cerebrovascular reserve capacity of spontaneous hypertensive rat（SHR）, and compared with pathological re-sults, then to evaluate the clinical application value in patients with subclinical cerebral ischemia. Methods：Totally of 10 rats in normal control group and 10 rats in SHR group underwent cerebral CT perfusion scanning before and and 1.5-2.0 h after intragastric administration of methazolamide. The cerebral blood volume（CBV）,cerebral blood flow（CBF）, mean transit time （MTT）, time to peak（TTP） values of region of interest were measured before and after methazolamide stress test and for statis-tical analysis. The arteriolar wall thickness and microcirculation capillary network were observed under light microscope of HE staining of paraffin section. TTC staining was performed to make sure the brain without cerebral infarction. Results： CT perfusion scanning： the differences of the CBV, CBF, MTT and TTP values between the resting state and load state of the normal control group had statistical significance（P＆lt;0.05）, and the CBV, CBF values increased, the MTT, TTP values short-ened in the load state. There were no statistical significant differences of the CBV, CBF, MTT and TTP values between the resting state and load state of the SHR group. The CBV, CBF, MTT and TTP values between the two groups of rats had sig-nificant differences（P＆lt;0.05） both in the resting state and the load state, and the CBV, CBF values of the SHR group de-creased, MTT, TTP values prolonged. HE staining showed that the remodeling, wall thickening and hardening of the arteri-oles and small arteries, and the relative reduction of the number of the microcirculation capillary network in the SHR group. TTC staining showed that the brain tissue of SHR had no cerebral infarction. Conclusions： The cerebrovascular reserve of the SHR decreases compared with the normal. CT perfus

关 键 词：CT灌注成像 脑血管储备功能 脑缺血性疾病 原发性高血压大鼠 

分 类 号：R743[医药卫生—神经病学与精神病学]