超选择性脑动脉栓塞兔脑缺血半暗带及CTPI灌注参数的变化  

The variation of cerebral ischemic penumbra and CTPI perfusion parameters of New Zealand experiment rabbit with supper selective cerebral artery embolization

作　　者：李岳勇[1,2] 吴英宁 韦勤将[1] 姜秋兰 蒋天鹏[3] 周石 韦忠恒 LI Yueyong;WU Yingning;WEI Qinjiang;JIANG Qiulan;JIANG Tianpeng;ZHOU Shi;WEI Zhongheng(Department of Interventional Radiology,the Affiliated Hospital of Youjiang Medical University for Nationalites,Baise,Guangxi 533000,China;Clinical College,Jinan University,Guangzhou,Guangdong 510630,China;Department of Interventional Radiology,the Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550004,China)

机构地区：[1]右江民族医学院附属医院介入科,广西百色533000 [2]暨南大学临床学院,广州510630 [3]贵州医科大学附属医院放射介入科,贵阳550004

出　　处：《重庆医学》2019年第23期3961-3964,3969,共5页Chongqing medicine

基　　金：广西壮族自治区卫生和计划生育委员会科技计划项目（Z2016419）;广西自然科学基金项目（2018JJA140853）;广西壮族自治区教育厅高校科研基金项目（YB2014290）

摘　　要：目的 探讨介入技术建立兔急性期脑梗死模型,以及脑缺血半暗带(IP)、CT灌注成像(CTPI)改变对早期脑梗死的诊断价值。方法 选择新西兰大白兔16只,经股动脉穿刺插管于颅内大脑中动脉注入自体血栓,制作急性脑梗死模型,行数字血管减影(DSA)脑血管造影;术后2、6h行CTPI检查,测量灌注栓塞侧及对侧健侧区局部脑血流量(rCBF)、局部脑血容量(rCBV)、平均通过时间(MTT)、造影剂达峰时间(TTP)值,评价CTPI诊断早期脑缺血的准确性,并预判脑IP范围。结果 16只新西兰大白兔均成功插管于大脑中动脉进行栓塞,DSA显示大脑中动脉分支减少,造模成功率为100%。术后2、6h分别行CTPI检查,术后2h显示大脑中动脉供血区栓塞中心区rCBF和rCBV值下降,MTT和TTP延长,与对侧健侧区对比CTPI各参数值,差异均有统计学意义(P<0.01),并显示脑IP范围。术后6h行CTPI检查,提示栓塞中心区rCBF、rCBV值明显下降,MTT及TTP值明显延长,栓塞中心区、对侧健侧区CTPI各参数值对比,差异均有统计学意义(P<0.01)。结论 经介入技术制作兔脑梗死模型具有操作简便、成功率高的优点,是理想的造模方式;术后2h行CTPI即可准确显示脑缺血改变,是诊断急性脑梗死有效的检查方法。Objective To explore the establishment of acute cerebral infarction model in rabbits by using interventional method,and evaluate the diagnostic value of cerebral ischemic penumbra(IP)and CT perfusion imaging(CTPI)changes in early cerebral infarction.Methods A total of 16 healthy New Zealand white rabbit were selected in this study.The autologous thrombus was injected into the middle cerebral artery through the femoral artery puncture to establish the model of acute cerebral infarction,and digital angiography(DSA)cerebral angiography was performed.The CTPI was performed at 2 and 6 h after the operation.The values of regional cerebral blood flow(rCBF),regional cerebral blood volume(rCBV),mean transit time(MTT)and contrast agent peak time(TTP)in the lesions and the normal contralateral regions were measured.Moreover,the accuracy of CTPI in the diagnosis of early cerebral ischemia was evaluated,and the scope of brain IP was assessmented.Results Super-selective catheterization of internal carotid artery and injection of auto-blood clots were successfully accomplished in all 16 rabbits.The DSA showed a decrease in the number of middle cerebral artery branches,and the success rate of modeling was 100%.CTPI was performed at 2 and 6 h after operation.At 2 h after embolism,CTPI showed the values of rCBF and rCBV in the cerebral ischemia region were decreased,and the MTT and TTP were prolonged;compared the values of CTPI parameters in the cerebral ischemia region with those in the contralateral mirror side,there were statistically significant differences(P<0.01).And accurately displaied the scope of IP.The examination at 6 h after operation showed that the values of rCBF and rCBV in the central of embolization got a step further decrease,and the MTT and TTP were more obviously prolonged;compared the values of CTPI parameters in the cerebral ischemia region with those in the contralateral mirror side,there were statistically significant differences(P<0.01).Conclusion The model of acute cerebral infarction in rabbits with int

关 键 词：脑梗死 疾病模型 动物 体层摄影术 X线计算机 灌注成像 兔 

分 类 号：R816.1[医药卫生—放射医学]