兔坐骨神经牵拉损伤与修复的纤维束示踪成像与病理对照分析
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摘要
目的:制作兔坐骨神经急性牵拉伤可逆损伤模型,探讨纤维示踪成像(DTT)评价坐骨神经急性牵拉伤的可行性及准确性。方法:选取32只新西兰白兔,牵拉右侧坐骨神经建立退变与修复模型;左后肢为假手术侧。于术后1、3 d及1、2、3、4、6、8周行MR扩散张量成像并行纤维示综,测量神经纤维束长度及平均神经纤维密度指数。MRI检查完毕,于各时间点取1只兔坐骨神经行病理检查。结果:坐骨神经牵拉伤术后1 d~2周损伤侧纤维束长度与假手术侧有明显差异(P<0.05);3~8周损伤侧坐骨神经纤维束长度与假手术侧无明显差异。术后1 d~8周损伤侧平均神经纤维密度指数与假手术侧有明显统计学差异(P<0.05);牵拉伤后1 d牵拉段可见较多髓鞘扭曲,3 d牵拉段轴索明显崩解。2周神经退变与再生并存,8周神经纤维再生基本成熟。结论:神经纤维束长度及平均神经纤维密度指数~时间曲线与病理学的变化趋势相一致,可作为评价神经损伤退变及再生的补充手段。
Objective To make sciatic nerve traction injury models of rabbit, in order to prospectively evaluate possibility and accuracy of diffusion tensor tracking(DTT) in sciatic nerve injures. Methods The right sciatic nerves of 32 New Zealand white rabbits were selected for traction injury, and the left sciatic nerves were the sham operation side. DTI scan was performed before and after the operation on 1st day, 3rd day, and 1 week, 2,3, 4, 6 and 8th week respectively, and DTT was reconstructed. Then the length of reconstructed fiber tracts and fiber density index were calculated. After the MRI scan, the sciatic nerve was removed to perform pathologic examination at different time points. Results The difference of the length of reconstructed fiber tracts between nerve traction injury and sham operation side was significant at 1 day ~ 2 weeks after operation(P < 0.05), while the difference was not significant at 3 ~ 8 weeks.The fiber density index of nerve traction injury and sham operation side was significantly different at 1 day ~ 8 weeks(P < 0.05). 1day after operation, myelin sheath of traction portion was obviously twisting. 3 days after operation, a large amount of myelin sheath broke down. 2 weeks after operation,axon, myelin sheath degeneration and regeneration coexisted at the same time. 8 weeks after operation, nerve fibers regenerated and restored to normal structure. Conclusion The length time curve and density index-time curve of nerve traction injury are consistent with the changes of pathology, which can be used as a supplementary method to evaluate the degeneration and regeneration in nerve injury.
Objective To make sciatic nerve traction injury models of rabbit, in order to prospectively evaluate possibility and accuracy of diffusion tensor tracking(DTT) in sciatic nerve injures. Methods The right sciatic nerves of 32 New Zealand white rabbits were selected for traction injury, and the left sciatic nerves were the sham operation side. DTI scan was performed before and after the operation on 1st day, 3rd day, and 1 week, 2,3, 4, 6 and 8th week respectively, and DTT was reconstructed. Then the length of reconstructed fiber tracts and fiber density index were calculated. After the MRI scan, the sciatic nerve was removed to perform pathologic examination at different time points. Results The difference of the length of reconstructed fiber tracts between nerve traction injury and sham operation side was significant at 1 day ~ 2 weeks after operation(P < 0.05), while the difference was not significant at 3 ~ 8 weeks.The fiber density index of nerve traction injury and sham operation side was significantly different at 1 day ~ 8 weeks(P < 0.05). 1day after operation, myelin sheath of traction portion was obviously twisting. 3 days after operation, a large amount of myelin sheath broke down. 2 weeks after operation,axon, myelin sheath degeneration and regeneration coexisted at the same time. 8 weeks after operation, nerve fibers regenerated and restored to normal structure. Conclusion The length time curve and density index-time curve of nerve traction injury are consistent with the changes of pathology, which can be used as a supplementary method to evaluate the degeneration and regeneration in nerve injury.
引文
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[7]陈妙玲,李新春,陈镜聪,等.磁共振扩散张量成像定量分析正常臂丛神经[J].中国医学影像技术,2012,28(1):77-81.
[8]孙敬,徐菡,郭静,等.弥散张量成像技术初步评价视放射[J].中国医学影像技术,2009,25(1),50-53.
[9]Shen J,Zhou CP,Zhong XM,et al.T1 and T2 measurements in acute peripheral nerve traction injury in rabbits[J].Radiology,2010,254(3):729-738.
[10]陈德英,程赛宇,肖艳,等.坐骨神经损伤修复过程中髓鞘变化的形态学研究[J].创伤外科杂志,2002,4(3):149-151.
[2]黄雪莹,詹茸婷,孙胜玉,等.磁共振扩散张量纤维束成像在大脑初级运动皮层区肿瘤术前评估中的应用[J].实用医学杂志,2013,29(19):3207-3209.
[3]陈镜聪,李新春,孙褕鹏,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(9):1647-1650.
[4]孙褕鹏,李新春,许乙凯,等.扩散张量成像评估兔坐骨神经挤压伤[J].中国医学影像技,2013,29(3):325-330.
[5]Li X,Chen J,Hong G,et al.In vivo DTI longitudinal measurements of acute sciatic nerve traction injury and the association with pathological and functional changes[J].Eur J Radiol,2013,82(11):e707-e714.
[6]Lehmann HC,Zhang J,Mori S,et al.Diffusion tensor imaging to assess axonal regeneration in peripheral nerves[J].Exp Neurol,2010,223(1):238-244.
[7]陈妙玲,李新春,陈镜聪,等.磁共振扩散张量成像定量分析正常臂丛神经[J].中国医学影像技术,2012,28(1):77-81.
[8]孙敬,徐菡,郭静,等.弥散张量成像技术初步评价视放射[J].中国医学影像技术,2009,25(1),50-53.
[9]Shen J,Zhou CP,Zhong XM,et al.T1 and T2 measurements in acute peripheral nerve traction injury in rabbits[J].Radiology,2010,254(3):729-738.
[10]陈德英,程赛宇,肖艳,等.坐骨神经损伤修复过程中髓鞘变化的形态学研究[J].创伤外科杂志,2002,4(3):149-151.
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