论文部分内容阅读
目的用CT灌注成像(CTPI)和病理学方法对急性脑静脉闭塞动物模型进行评价。材料与方法家猫22只,随机分为2组(手术组18只,假手术组4只)。手术组采用开颅上矢状窦穿刺注射液体栓塞剂———醋酸纤维素聚合物(CAP)制备急性脑静脉闭塞动物模型,术后1、3、6、12、24、48h用CTPI对各组模型的脑血流动力学改变进行观察,其结果和病理学对照研究。假手术组只做钻孔颅骨开窗暴露上矢状窦,但不进一步操作。结果手术组12只猫CTPI出现脑血流异常灌注区。术后1h,病变表现为局部脑血容量(rCBV)轻度增加,局部脑血流量(rCBF)轻度降低,平均通过时间(MTT)稍延长;3~6h后病变中心区主要表现为rCBV和rCBF降低,而病变边缘区rCBV增加或正常或轻度降低,rCBF降低;12~24h后病变中心区和边缘区rCBV和rCBF均明显降低。大体病理学检查上矢状窦、桥静脉及皮层静脉内见CAP凝固呈铸型改变,3h后病变区见伊文思蓝不同程度蓝染。显微病理学检查10只猫出现脑实质损害,病变以血管源性水肿为主,12h后出现出血性脑梗死。假手术组4只猫均未见上述各种异常表现。结论功能CT灌注成像是评价急性脑静脉闭塞模型血流动力学改变的一种准确、敏感的方法,可早期评价脑实质损害的程度。
Objective To evaluate the animal model of acute cerebral venous occlusion by CT perfusion imaging (CTPI) and pathology. Materials and Methods 22 domestic cats were randomly divided into 2 groups (18 in operation group and 4 in sham operation group). In the operation group, acute cerebral venous occlusion was established by injecting liquid embolism agent (CAP) into the superior sagittal sinus of the craniotomy. At 1, 3, 6, 12, 24 and 48 h after operation, Cerebral hemodynamic changes were observed in the model group, and the results were compared with pathology. The sham-operated group exposed only the sagittal sinus by drilling the cranial fenestration without further manipulation. Results The CTPI of 12 cats in the operation group showed cerebral perfusion abnormalities. At 1 hour after operation, the lesion showed a slight increase of local cerebral blood volume (rCBV), a slight decrease of local cerebral blood flow (rCBF) and a slight prolongation of mean transit time (MTT). The central lesion showed rCBV and rCBF decreased, while the rCBV in the marginal zone of the lesion increased or decreased normally or slightly, while the rCBF decreased. The rCBV and rCBF in the center and marginal zone of the lesion decreased significantly after 12 ~ 24h. Gross pathological examination of the sagittal sinus, bridging vein and cortical vein to see the CAP coagulation was cast change, 3h after the lesion area to see Evans blue blue dye to varying degrees. Microscopic examination of 10 cats revealed parenchymal lesions in the brain, with vasogenic edema predominantly and hemorrhagic cerebral infarction 12 h later. Sham-operated group of 4 cats have not seen the above abnormalities. Conclusion Functional CT perfusion imaging is an accurate and sensitive method to evaluate the hemodynamic changes of acute cerebral venous occlusion model. It can evaluate the extent of brain parenchymal damage early.