磁共振灌注加权成像对家兔急性脑出血针刺疗效的评价
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摘要
目的:探讨磁共振灌注加权成像(PWI)在评价家兔急性脑出血针刺疗效中的价值。方法:雄性健康新西兰兔25只,利用随机数字表法随机分为空白组5只,模型对照组10只,针刺治疗组10只,采用自体血注入法复制急性脑出血动物模型,针刺治疗组造模成功后每隔24 h针刺一次,分别于造模后2 h、3 d和7 d行PWI检查,观察血肿周围及对侧相对脑血流量(rCBF)及对比剂平均通过时间(MTT)的变化,并记录相应数据,采用单因素方差分析及LSD检验进行分析。结果:兔脑出血模型建立后2 h即可观察到脑灌注损伤改变,针刺治疗组较模型对照组血肿周围及对侧血流灌注的改善更加明显,即不同时间点MTT较模型对照组缩短、rCBF较模型对照组增加,两者之间差异有统计学意义(F值均>1,P<0.01)。结论:PWI能够客观评价针刺干预家兔急性脑出血后血肿及其周围组织的血流动力学改变,是研究针刺治疗急性出血性脑中风机制的可靠的影像学方法。
Objective:To explore the value of MR perfusion weighted imaging in the evaluation of acupuncture effect of rabbit's acute intracerebral hemorrhage.Methods:Twenty-five male New Zealand white rabbits were randomly divided into untreated control group (5 cases) ,model control group (10 cases) ,acupuncture group (10 cases).Using the method of autologous blood injection we replicated acute intracerebral hemorrhage model.Acupuncture group accepted acupuncture treatment once every 24 hours after the modeling.PWI MR examination was performed for all models at different points after models established (2 h, 3 d,7 d).The changes of rCBF (regional cerebral blood flow),and MTT (mean transit time of contrast agent) in the regions of hematoma and it's contralateral were observed by perfusion weighted imaging (PWI) ,then record the relative data.One-factor analysis of variance and LSD test were used for analysis.Results:The perfusion injury in the brain could be observed just 2 h after intracerebral hemorrhage model was established.About blood flow in the hematoma and it's contralateral region,acupuncture group improved more obvious than model control group:MTT was shorter and rCBF was increased at different time points compared with control group.There were significant differences between the two (the F values were> 1,P <0.01). Conclusion:MR PWI can objectively assess the hemodynamic changes in acute intracerebral hemorrhage of rabbit after they accepted the acupuncture treatment,which is the reliable imaging method for studying acupuncture mechanism in acute hemorrhagic stroke.
Objective:To explore the value of MR perfusion weighted imaging in the evaluation of acupuncture effect of rabbit's acute intracerebral hemorrhage.Methods:Twenty-five male New Zealand white rabbits were randomly divided into untreated control group (5 cases) ,model control group (10 cases) ,acupuncture group (10 cases).Using the method of autologous blood injection we replicated acute intracerebral hemorrhage model.Acupuncture group accepted acupuncture treatment once every 24 hours after the modeling.PWI MR examination was performed for all models at different points after models established (2 h, 3 d,7 d).The changes of rCBF (regional cerebral blood flow),and MTT (mean transit time of contrast agent) in the regions of hematoma and it's contralateral were observed by perfusion weighted imaging (PWI) ,then record the relative data.One-factor analysis of variance and LSD test were used for analysis.Results:The perfusion injury in the brain could be observed just 2 h after intracerebral hemorrhage model was established.About blood flow in the hematoma and it's contralateral region,acupuncture group improved more obvious than model control group:MTT was shorter and rCBF was increased at different time points compared with control group.There were significant differences between the two (the F values were> 1,P <0.01). Conclusion:MR PWI can objectively assess the hemodynamic changes in acute intracerebral hemorrhage of rabbit after they accepted the acupuncture treatment,which is the reliable imaging method for studying acupuncture mechanism in acute hemorrhagic stroke.
引文
[1] Sacco S,Marini CToni D,et al.Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry [J].Stroke,2009,40:394-399．
[2] Shiflett SC.Does acupuncture work for stroke rehabilitation:what do recent clinical trials really show[J].Top Stroke Rehabil,2007,14:40-58．
[3] 林文注,王佩.实验针灸学·家兔的常用针灸穴位[M].上海:上海科学技术出版社,1994:271．
[4] Schellinger PD,Fiebach JB,Hoffmann K,et al.Stroke MRI in intracerebral hemorrhage:is there a perihemorrhagic penum-bra[J].Stroke,2003,34:1674-1679．
[5] 高波,刘奉立,张维新.MR灌注加权成像在脑血管性疾病中的 应用进展[J].中国中西医结合影像学杂志,2010,8(3) :259-262．
[6] Manka CTraber F,Gieseke J,et al.Three-dimensional dynamic susceptibility-weighted perfusion MR imaging at 3． 0 T:feasibility and contrast agent dose[J].Radiology,2005,234 :869-877．
[7] 王苇,殷小萍,张新江,等.脑出血后血肿周围组织的磁共振灌注成像研究[J].放射学实践,2006,21(10) :989 991．
[8] 丁为国,李丽欣,许红,等.针刺百会穴对急性脑血肿大鼠局部脑血流量的影响[J].上海针灸杂志,2003,22(5) :7-9．
[9] 李京京,鲍春龄,东贵荣.头部腧穴透刺治疗出血性中风偏瘫的临床观察[J].针灸临床杂志,2005,21(3) :29 30．
[2] Shiflett SC.Does acupuncture work for stroke rehabilitation:what do recent clinical trials really show[J].Top Stroke Rehabil,2007,14:40-58．
[3] 林文注,王佩.实验针灸学·家兔的常用针灸穴位[M].上海:上海科学技术出版社,1994:271．
[4] Schellinger PD,Fiebach JB,Hoffmann K,et al.Stroke MRI in intracerebral hemorrhage:is there a perihemorrhagic penum-bra[J].Stroke,2003,34:1674-1679．
[5] 高波,刘奉立,张维新.MR灌注加权成像在脑血管性疾病中的 应用进展[J].中国中西医结合影像学杂志,2010,8(3) :259-262．
[6] Manka CTraber F,Gieseke J,et al.Three-dimensional dynamic susceptibility-weighted perfusion MR imaging at 3． 0 T:feasibility and contrast agent dose[J].Radiology,2005,234 :869-877．
[7] 王苇,殷小萍,张新江,等.脑出血后血肿周围组织的磁共振灌注成像研究[J].放射学实践,2006,21(10) :989 991．
[8] 丁为国,李丽欣,许红,等.针刺百会穴对急性脑血肿大鼠局部脑血流量的影响[J].上海针灸杂志,2003,22(5) :7-9．
[9] 李京京,鲍春龄,东贵荣.头部腧穴透刺治疗出血性中风偏瘫的临床观察[J].针灸临床杂志,2005,21(3) :29 30．