坐骨神经牵拉伤模型MR扩散张量成像与病理的对照
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摘要
背景:磁共振弥散张量成像可以显示周围神经损伤的弥散变化并进行定量研究,因而在显示神经损伤及再生方面具有良好的应用前景。目的:探讨兔坐骨神经急性牵拉伤弥散张量成像的可靠性,明确弥散张量参数在神经损伤诊断中的价值及病理学基础。方法:选取32只新西兰白兔建立右后肢坐骨神经退变与修复模型,左后肢为假手术侧。采用1.5 T MRI机于术后1 d,3 d,1周,2周,3周,4周,6周,8周行双侧坐骨神经弥散张量成像,进行DTT重建,测量各向异性分数、表观扩散系数;然后进行病理检查。结果与结论:牵拉伤后1 d弥散张量成像仅显示神经近段,损伤段及远段中断;牵拉伤后1周远段出现细、短纤维束;牵拉伤后2-6周远段纤维束增多、增粗;牵拉伤8周神经纤维大部分恢复正常。1 d-8周牵拉段、牵拉远段各向异性分数值与假手术侧差异有显著性意义(P<0.05);1 d-1周牵拉近段各向异性分数值与假手术侧差异有显著性意义(P<0.05)。1-8周不同牵拉段表观扩散系数值与假手术侧差异均无显著性意义。神经牵拉伤早期各向异性分数值下降的病理改变是髓鞘板层疏松,崩解,轴索崩解;各向异性分数值升高的病理基础是髓鞘、轴索再生。结果可见DTT纤维示踪成像可清晰、直观、早期显示兔坐骨神经牵拉伤的异常改变,各向异性分数值测量可作为监测坐骨神经牵拉伤后退变及再生的敏感方法。
BACKGROUND: Magnetic resonance diffusion tensor imaging can display the dispersion changes of peripheral nerve injury and be used to conduct quantitative research, so it has good application prospects in displaying the nerve injury and regeneration.OBJECTIVE: To investigate the possibility of magnetic resonance diffusion tensor imaging of rabbit acute sciatic nerve traction injury, and to figure out the value of diffusion tensor parameters in the diagnosis of peripheral nerve injuries and to reveal the pathologic basis.METHODS: The right hind limb sciatic nerves of 32 New Zealand white rabbits were selected to make the regeneration and repair models, the left hind limb nerves as the sham-operation side. Diffusion tensor imaging examination of sciatic nerves were performed at 1 and 3 days, 1, 2, 3, 4, 6 and 8 weeks after operation with 1.5 T MRI. Fractional anisotropy and apparent diffusion coefficient were measured through diffusion tensor tracingreconstruction, and then the pathological examination was performed.RESULTS AND CONCLUSION: Diffusion tensor imaging revealed only the proximal nerve, injured nerve as well as the middle of the distal nerve at 1 day after traction injury. At 1 week, the nerve of distal portion appeared thinner and shorter fiber bundle. At 2-6 weeks after operation, the fiber bundle was increased and thickened. At 8weeks after operation, the distal nerve fibers had nearly restored to the level before injury. There was significant difference in the fractional anisotropy value of traction portion and distal portions between traction injury and sham-operation group at 1 day-8 weeks after operation(P < 0.05). While there was significant difference in the fractional anisotropy value of proximal traction portion between traction injury and sham-operation group 1 day-1 week after operation(P < 0.05). There were no significant differences in the apparent diffusion coefficient values between traction injury and sham-operation group at 1 day-8 weeks after operation. Fall of fractional anisotropy value in the early stage of nerve traction injury was the result of myelin sheath broke down and axonal disintegrated; recovery of fractional anisotropy value resulted from myelin sheath proliferated and myelin sheath grew slowly to mature. Diffusion tensor tracing can show the abnormal change of the sciatic nerve with traction injury in rabbit clearly and early, and the measurement of fractional anisotropy value can be used as the sensitive method to monitor the degeneration and regeneration after nerve traction injury.
BACKGROUND: Magnetic resonance diffusion tensor imaging can display the dispersion changes of peripheral nerve injury and be used to conduct quantitative research, so it has good application prospects in displaying the nerve injury and regeneration.OBJECTIVE: To investigate the possibility of magnetic resonance diffusion tensor imaging of rabbit acute sciatic nerve traction injury, and to figure out the value of diffusion tensor parameters in the diagnosis of peripheral nerve injuries and to reveal the pathologic basis.METHODS: The right hind limb sciatic nerves of 32 New Zealand white rabbits were selected to make the regeneration and repair models, the left hind limb nerves as the sham-operation side. Diffusion tensor imaging examination of sciatic nerves were performed at 1 and 3 days, 1, 2, 3, 4, 6 and 8 weeks after operation with 1.5 T MRI. Fractional anisotropy and apparent diffusion coefficient were measured through diffusion tensor tracingreconstruction, and then the pathological examination was performed.RESULTS AND CONCLUSION: Diffusion tensor imaging revealed only the proximal nerve, injured nerve as well as the middle of the distal nerve at 1 day after traction injury. At 1 week, the nerve of distal portion appeared thinner and shorter fiber bundle. At 2-6 weeks after operation, the fiber bundle was increased and thickened. At 8weeks after operation, the distal nerve fibers had nearly restored to the level before injury. There was significant difference in the fractional anisotropy value of traction portion and distal portions between traction injury and sham-operation group at 1 day-8 weeks after operation(P < 0.05). While there was significant difference in the fractional anisotropy value of proximal traction portion between traction injury and sham-operation group 1 day-1 week after operation(P < 0.05). There were no significant differences in the apparent diffusion coefficient values between traction injury and sham-operation group at 1 day-8 weeks after operation. Fall of fractional anisotropy value in the early stage of nerve traction injury was the result of myelin sheath broke down and axonal disintegrated; recovery of fractional anisotropy value resulted from myelin sheath proliferated and myelin sheath grew slowly to mature. Diffusion tensor tracing can show the abnormal change of the sciatic nerve with traction injury in rabbit clearly and early, and the measurement of fractional anisotropy value can be used as the sensitive method to monitor the degeneration and regeneration after nerve traction injury.
引文
[1]Meek MF,Stenekes MW,Hoogduin HM,et al.In vivo three-dimensional reconstruction of human median nerves by diffusion tensor imaging.Exp Neurol.2006;198(2):479-482.
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[6]Hiltunen J,Suortti T,Arvela S,et al.Diffusion tensor imaging and tractography of distal peripheral nerves at 3 T.Clin Neurophysiol.2005;116(10):2315-2323.
[7]陈镜聪,李新春,孙翀鹏,等.正常成人近段坐骨神经的弥散张量成像[J].中国组织工程研究,2012,16(9):1647-1650.
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[10]van der Jagt PK,Dik P,Froeling M,et al.Architectural configuration and microstructural properties of the sacral plexus:a diffusion tensor MRI and fiber tractography study.Neuroimage.2012;62(3):1792-1799.
[11]孙翀鹏,许乙凯,陈妙玲,等.1.5T MR兔坐骨神经弥散张量纤维束示踪b值优化[J].中国医学影像技术,2011,27(8):1528-1532.
[12]Lehmann HC,Zhang J,Mori S,et al.Diffusion tensor imaging to assess axonal regeneration in peripheral nerves.Exp Neurol.2010;223(1):238-244.
[13]Takagi T,Nakamura M,Yamada M,et al.Visualization of peripheral nerve degeneration and regeneration:monitoring with diffusion tensor tractography.Neuroimage.2009;44(3):884-892.
[14]Wessig C,Koltzenburg M,Reiners K,et al.Muscle magnetic resonance imaging of denervation and reinnervation:correlation with electrophysiology and histology.Exp Neurol.2004;185(2):254-261.
[15]李新春,方学文,陈键宇,等.兔坐骨神经挤压伤的MRI与SEP对比研究[J].中国中西医结合影像学杂志,2007,5(3):178-180.
[16]Shen J,Duan XH,Cheng LN,et al.In vivo MR imaging tracking of transplanted mesenchymal stem cells in a rabbit model of acute peripheral nerve traction injury.J Magn Reson Imaging.2010;32(5):1076-1085.
[17]Duan XH,Cheng LN,Zhang F,et al.In vivo MRI monitoring nerve regeneration of acute peripheral nerve traction injury following mesenchymal stem cell transplantation.Eur J Radiol.2012;81(9):2154-2160.
[18]周翠屏,成丽娜,段小慧,等.兔坐骨神经急性牵拉伤模型的制作:MRI与病理对照[J].中国医学影像技术,2009,25(S1):5-7.
[19]Morisaki S,Kawai Y,Umeda M,et al.In vivo assessment of peripheral nerve regeneration by diffusion tensor imaging.J Magn Reson Imaging.2011;33(3):535-542.
[20]Koeppen AH.Wallerian degeneration:history and clinical significance.J Neurol Sci.2004;220(1-2):115-117.
[2]Tagliafico A,Calabrese M,Puntoni M,et al.Brachial plexus MR imaging:accuracy and reproducibility of DTI-derived measurements and fibre tractography at 3.0-T.Eur Radiol.2011;21(8):1764-1771.
[3]李新春,陈健宇,刘庆余,等.正常臂丛节后神经MR神经成像术[J].中国医学影像技术,2004,20(1):105-107.
[4]Jambawalikar S,Baum J,Button T,et al.Diffusion tensor imaging of peripheral nerves.Skeletal Radiol.2010;39(11):1073-1079.
[5]张帆,李坤成,于春水,等.兔坐骨神经扩散张量纤维束示踪[J].放射学实践,2007,22(9):905-907.
[6]Hiltunen J,Suortti T,Arvela S,et al.Diffusion tensor imaging and tractography of distal peripheral nerves at 3 T.Clin Neurophysiol.2005;116(10):2315-2323.
[7]陈镜聪,李新春,孙翀鹏,等.正常成人近段坐骨神经的弥散张量成像[J].中国组织工程研究,2012,16(9):1647-1650.
[8]Tagliafico A,Calabrese M,Puntoni M,et al.Brachial plexus MR imaging:accuracy and reproducibility of DTI-derived measurements and fibre tractography at 3.0-T.Eur Radiol.2011;21(8):1764-1771.
[9]Andreisek G,White LM,Kassner A,et al.Diffusion tensor imaging and fiber tractography of the median nerve at 1.5T:optimization of b value.Skeletal Radiol.2009;38(1):51-59.
[10]van der Jagt PK,Dik P,Froeling M,et al.Architectural configuration and microstructural properties of the sacral plexus:a diffusion tensor MRI and fiber tractography study.Neuroimage.2012;62(3):1792-1799.
[11]孙翀鹏,许乙凯,陈妙玲,等.1.5T MR兔坐骨神经弥散张量纤维束示踪b值优化[J].中国医学影像技术,2011,27(8):1528-1532.
[12]Lehmann HC,Zhang J,Mori S,et al.Diffusion tensor imaging to assess axonal regeneration in peripheral nerves.Exp Neurol.2010;223(1):238-244.
[13]Takagi T,Nakamura M,Yamada M,et al.Visualization of peripheral nerve degeneration and regeneration:monitoring with diffusion tensor tractography.Neuroimage.2009;44(3):884-892.
[14]Wessig C,Koltzenburg M,Reiners K,et al.Muscle magnetic resonance imaging of denervation and reinnervation:correlation with electrophysiology and histology.Exp Neurol.2004;185(2):254-261.
[15]李新春,方学文,陈键宇,等.兔坐骨神经挤压伤的MRI与SEP对比研究[J].中国中西医结合影像学杂志,2007,5(3):178-180.
[16]Shen J,Duan XH,Cheng LN,et al.In vivo MR imaging tracking of transplanted mesenchymal stem cells in a rabbit model of acute peripheral nerve traction injury.J Magn Reson Imaging.2010;32(5):1076-1085.
[17]Duan XH,Cheng LN,Zhang F,et al.In vivo MRI monitoring nerve regeneration of acute peripheral nerve traction injury following mesenchymal stem cell transplantation.Eur J Radiol.2012;81(9):2154-2160.
[18]周翠屏,成丽娜,段小慧,等.兔坐骨神经急性牵拉伤模型的制作:MRI与病理对照[J].中国医学影像技术,2009,25(S1):5-7.
[19]Morisaki S,Kawai Y,Umeda M,et al.In vivo assessment of peripheral nerve regeneration by diffusion tensor imaging.J Magn Reson Imaging.2011;33(3):535-542.
[20]Koeppen AH.Wallerian degeneration:history and clinical significance.J Neurol Sci.2004;220(1-2):115-117.
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