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目的探索运用磁共振扩散张量成像(MR-DTI)定量评价脉络宁注射液对非压迫性腰神经根炎的疗效。方法选取巴马小型猪9只,分入A组、B组、C组,各3只,在CT引导下建立非压迫性腰神经根炎模型,各组于造模后14d硬膜外分别注射脉络宁(10mL)、生理盐水(10mL)、消炎液(10mL),造模前、造模后14d、治疗前均进行MR-DTI扫描,治疗后3、7、14d分别从各组取出1只实验猪进行MR-DTI扫描后处死并取神经根标本进行免疫组织化学检测,在MR-DTI图像中测量神经根各向异性分数(FA)值,对FA值和免疫组织化学结果进行统计学分析。结果 MR-DTI:各组造模后FA值均降低(P<0.05);A组治疗后14dFA值回升,与治疗前比较,差异有统计学意义(P<0.05);A组治疗后3、7dFA值无明显上升,A、B两组间比较,差异无统计学意义(P>0.05),但C组FA值回升较其他两组早且迅速(P<0.05);治疗后14d,A组FA值回升,双侧神经根FA值分别与B组、C组比较,差异均无统计学意义(P>0.05),而B组和C组间FA值比较差异有统计学意义(P<0.05)。免疫组织化学:治疗后7d,A组神经组织肿瘤坏死因子α(TNF-α)的积分吸光度值(IA值)开始下降;治疗后14d,A组与C组TNF-αIA值较B组明显降低,差异有统计学意义(P<0.05)。结论脉络宁注射液对非压迫性腰神经根炎具有一定疗效,并可用DTI对其进行评价。
Objective To explore the use of MR diffusion tensor imaging (MR-DTI) quantitative evaluation of Mailuoning injection on non-compressive lumbar radiculitis efficacy. Methods Nine Bama miniature pigs were randomly divided into group A, group B and group C, and each group was divided into three groups. CT-guided non-compressive lumbar radiculitis model was established. Each group was injected epidurally (10 mL), normal saline (10 mL) and anti-inflammatory fluid (10 mL). Before the model and 14 days after modeling, MR-DTI scanning was performed before treatment and 1 The experimental pigs were killed after MR-DTI scan and nerve root specimens were taken for immunohistochemistry. The anisotropy fraction (FA) value of nerve root was measured in MR-DTI images and the FA value and immunohistochemical results were statistically analyzed . RESULTS: FA-values of MR-DTI in each group were significantly lower than those in the control group (P <0.05); the FA values of group A increased 14 days after treatment, with statistical significance (P <0.05) (P <0.05). However, FA values in group C returned earlier and faster than those in other two groups (P <0.05). On the 14th day after treatment, group A showed no significant difference There was no significant difference in FA value between the two groups (P> 0.05), while FA value of bilateral nerve roots was not significantly different from that of B group and C group (P> 0.05) ). Immunohistochemistry: At 7 days after treatment, the integral absorbance value (TNF) of tumor necrosis factor alpha (TNF-α) began to decrease in group A; At 14 days after treatment, TNF-αIA in group A and group C was significantly lower than that in group B , The difference was statistically significant (P <0.05). Conclusion Mailuoning injection has some curative effect on non-compressive lumbar radiculitis, and can be evaluated by DTI.