增强磁共振成像在犬细菌性脑膜炎诊断中的应用
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摘要
为了评价钆喷酸葡胺(Gd-DTPA)增强磁共振影像技术对犬细菌性脑膜炎的诊断价值,将1岁龄本地犬种18只随机分为4组,其中细菌性脑膜炎模型有3组,每组各5只,分别通过小脑延髓池穿刺接种不同浓度(4×10~6、4×10~7、4×10~8CFU/mL)的大肠杆菌标准菌以建立犬细菌性脑膜炎模型;而空白对照组的3只犬,以等体积生理盐水替代大肠杆菌标准菌作对照组;观察各组造模前后犬的临床症状、体温、全血白细胞及脑脊液中白细胞数目等指标,并同时在造模前、造模后第1、3天对头部增强扫描,比较不同浓度组增强扫描影像学差异,观察犬脑解剖学和病理学方面的变化。结果,试验前后体温、全血白细胞数及脑脊液白细胞数的差异性显著;磁共振影像表现,空白对照组未见异常;低浓度组除胼胝体上部软膜有轻微高信号外未见其他异常;中等浓度组脑实质沟回加深、软膜明显增强,其他未见异常;高浓度组硬膜增厚、软膜明显增强、脑实质沟回加深、侧脑室中度扩张。解剖学结果与影像结果相符。结论,经小脑延髓池穿刺注射大肠杆菌能够成功诱导出脑膜炎,且通过控制细菌的浓度可造成病变程度不同的脑膜炎;增强磁共振成像技术对不同程度细菌性脑膜炎具有十分重要的诊断参考价值。
To evaluate the diagnostic value of Gd-DTPA enhanced magnetic resonance imaging in canine infected with different concertration of bacterial meningitis,eighteen 1 year old native dogs were randomly divided into 4 groups,3 bacterial meningitis model groups with 5 dogs in each.The models of canine bacterial meningitis were established by cerebellar medullary puncture using different concentrations(4×10~6,4×10~7,4×10~8CFU/mL) of Escherichia coli in each group,while an equal volume of saline was substituted for Escherichia coli in the blank control group with 3 dogs.The clinical symptoms of the animals after modeling were observed,and body temperature,whole blood leukocytes and leukocytes in the cerebrospinal fluid were recorded before and after modeling.Head-enhanced scan was performed pre-modeling and on day 1 and 3 post-modeling,and the imaging differences of MRI contrast enhancement in different concentration groups were compared,and the anatomical changes of the canine brain were observed.The results showed significantly differences in body temperature,whole blood leukocytes and cerebrospinal fluid leukocytes count.MRI images showed no abnormality in the blank control group,and no abnormalities were observed in the 4×106CFU/mL group except for slight enhance in the pia mater in the upper part of the corpus callosum.In the 4×107CFU/mL group,the brain parenchymasulcus was deepened and the pia mater was obviously enhanced while other abnormalities were not observed.The 4×108CFU/mL group results showed thickened dura and significantly enhanced pia mater.The brain parenchyma sulcus was deepened,and the lateral ventricle was moderately dilated.The anatomical results were consistent with the MRI image results.In conclusion,bacterial meningitis models were successfully established by puncture of Escherichia coli in the cisterna magna,and that the degrees of meningitis were controlled by the concentration of bacteria injected.The Enhanced magnetic resonance imaging had important diagnostic value for different degrees of bacterial meningitis.
To evaluate the diagnostic value of Gd-DTPA enhanced magnetic resonance imaging in canine infected with different concertration of bacterial meningitis,eighteen 1 year old native dogs were randomly divided into 4 groups,3 bacterial meningitis model groups with 5 dogs in each.The models of canine bacterial meningitis were established by cerebellar medullary puncture using different concentrations(4×10~6,4×10~7,4×10~8CFU/mL) of Escherichia coli in each group,while an equal volume of saline was substituted for Escherichia coli in the blank control group with 3 dogs.The clinical symptoms of the animals after modeling were observed,and body temperature,whole blood leukocytes and leukocytes in the cerebrospinal fluid were recorded before and after modeling.Head-enhanced scan was performed pre-modeling and on day 1 and 3 post-modeling,and the imaging differences of MRI contrast enhancement in different concentration groups were compared,and the anatomical changes of the canine brain were observed.The results showed significantly differences in body temperature,whole blood leukocytes and cerebrospinal fluid leukocytes count.MRI images showed no abnormality in the blank control group,and no abnormalities were observed in the 4×106CFU/mL group except for slight enhance in the pia mater in the upper part of the corpus callosum.In the 4×107CFU/mL group,the brain parenchymasulcus was deepened and the pia mater was obviously enhanced while other abnormalities were not observed.The 4×108CFU/mL group results showed thickened dura and significantly enhanced pia mater.The brain parenchyma sulcus was deepened,and the lateral ventricle was moderately dilated.The anatomical results were consistent with the MRI image results.In conclusion,bacterial meningitis models were successfully established by puncture of Escherichia coli in the cisterna magna,and that the degrees of meningitis were controlled by the concentration of bacteria injected.The Enhanced magnetic resonance imaging had important diagnostic value for different degrees of bacterial meningitis.
引文
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[4] KOEDEL U,PFISTER H W.Models of experimental bacterial meningitis:Role and limitations[J].Infectious Disease Clinics of North America,1999,13(3):549-577.
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[6]董燕,杜开先,贾天明,等.不同浓度肺炎链球菌造成大鼠脑膜炎模型的实验研究[J].中国实用神经疾病杂志,2016,19(11):23-24.DONG Yan,DU Kai-xian,JIA Tian-ming,et al.Study of bacterial meningitis models in rats induced by different concentration of bacteria[J].Chinese Journal of Practical Nervous Diseases,2016,19(11):23-24.(in Chinese)
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[10]凌晨,张奇文,宋康,等.大肠杆菌K1侵袭血脑屏障的研究进展[J].中国畜牧兽医,2017,44(3):686-691.LING Chen,ZHANG Qi-wen,SONG Kang,et al.Research progress of Escherichia coli K1 invading the blood-brain barrier[J].Chinese Journal of Animal Husbandry and Veterinary Medicine,2017,44(3):686-691.(in Chinese)
[11] JONGE R,SANDERS M,TERWEE C,et al.Unsuccessful validation of 2004 model for predicting academic or behavioural limitations after childhood bacterial meningitis[J].Acta Paediatrica,2014,102(12):553-559.
[12] OBERMAIER B,KLEIN M,KOEDEL U,et al.Disease models of acute bacterial meningitis[J].Drug Discovery Today Disease Models,2007,3(1):105-112.
[13]沈晓燕,姚大伟,龚国华,等.犬脑干脑炎的MRI诊断[J].中国兽医学报,2018,38(5):1019-1022.SHEN Xiao-yan,YAO Da-wei,GONG Guo-hua,et al.MRI diagnosis of canine brainstem encephalitis[J].Chinese Journal of Veterinary Science,2018,38(5):1019-1022.(in Chinese)
[14]周程远,王跃军,姚大伟,等.猫硬膜内髓外脊髓肿瘤的MRI诊断及手术治疗[J].畜牧与兽医,2018,50(1):129-132.ZHOU Cheng-yuan,WANG Yue-jun,YAO Da-wei,et al.The MRI diagnosis and surgical treatment of feline subdural tumor[J].Animal Husbandry and Veterinary Medicine,2018,50(1):129-132.(in Chinese)
[15] DIETEMANN J L,CORREIA B R,BOGORIN A,et al.Normal and abnormal meningeal enhancement:MRI features[J].Journal De Radiologie,2005,86(11):1659-1683.
[16] GUPTA RK,KATHURIA MK,PRADHAN S.Magnetization transfer MR imaging in CNS tuberculosis[J].American Society of Neuroradiology,1999,20(5):867-875.
[2] MERIC S M.Canine meningitis:A changing emphasis[J].Journal of Veterinary Internal Medicine,2010,2(1):26-35.
[3]李红,马林,苏家贵,等.磁共振增强减影技术在结核性脑膜炎中的运用[J].中国医学影像技术,2007,23(2):194-197.(in Chinese)LI Hong,MA Lin,SU Jia-gui,et al.Application of MR contrast-enhanced subtraction in tuberculous meningitis[J].Chinese Journal of Medical Imaging Technology,2007,23(2):194-197.
[4] KOEDEL U,PFISTER H W.Models of experimental bacterial meningitis:Role and limitations[J].Infectious Disease Clinics of North America,1999,13(3):549-577.
[5]刘俊举,张利彬,李东亮,等.家兔细菌性脑膜炎模型的建立[J].临床误诊误治,2006,19(4):7-8.LIU Jun-ju,ZHANG Li-bin,LI Dong-liang,et al.Establishment of rabbit model of bacterial meningitis[J].Journal of Clinical Misdiagnosis and Prevention,2006,19(4):7-8.(in Chinese)
[6]董燕,杜开先,贾天明,等.不同浓度肺炎链球菌造成大鼠脑膜炎模型的实验研究[J].中国实用神经疾病杂志,2016,19(11):23-24.DONG Yan,DU Kai-xian,JIA Tian-ming,et al.Study of bacterial meningitis models in rats induced by different concentration of bacteria[J].Chinese Journal of Practical Nervous Diseases,2016,19(11):23-24.(in Chinese)
[7] DUPONT M G,MORTELMANS L L,BALERIAUX-WAHA D,et al.Inflammatory Diseases of the Brain[M].Berlin Heidelberg:Springer,2009.129-131.
[8]郭文斐,黄晶,雷连成.脑膜炎性病原菌破坏血脑屏障机制的研究进展[J].山东医药,2018(10):95-98.GUO Wen-fei,HUANG Jing,LEI Lian-cheng.Research progress in the mechanism of meningeal inflammatory pathogens destroying blood-brain barrier[J].ShandongMedicine,2018(10):95-98.(inChinese)
[9]贺斌,赵忠新.急性细菌性脑膜炎和病毒性脑膜炎的鉴别诊断[J].临床神经病学杂志,2002,15(1):29-32.HE Bin,ZHAO Zhong-xin.Differential diagnosis of acute bacterial meningitis and viral meningitis[J].Journal of Clinical Neurology,2002,15(1):29-32.(in Chinese)
[10]凌晨,张奇文,宋康,等.大肠杆菌K1侵袭血脑屏障的研究进展[J].中国畜牧兽医,2017,44(3):686-691.LING Chen,ZHANG Qi-wen,SONG Kang,et al.Research progress of Escherichia coli K1 invading the blood-brain barrier[J].Chinese Journal of Animal Husbandry and Veterinary Medicine,2017,44(3):686-691.(in Chinese)
[11] JONGE R,SANDERS M,TERWEE C,et al.Unsuccessful validation of 2004 model for predicting academic or behavioural limitations after childhood bacterial meningitis[J].Acta Paediatrica,2014,102(12):553-559.
[12] OBERMAIER B,KLEIN M,KOEDEL U,et al.Disease models of acute bacterial meningitis[J].Drug Discovery Today Disease Models,2007,3(1):105-112.
[13]沈晓燕,姚大伟,龚国华,等.犬脑干脑炎的MRI诊断[J].中国兽医学报,2018,38(5):1019-1022.SHEN Xiao-yan,YAO Da-wei,GONG Guo-hua,et al.MRI diagnosis of canine brainstem encephalitis[J].Chinese Journal of Veterinary Science,2018,38(5):1019-1022.(in Chinese)
[14]周程远,王跃军,姚大伟,等.猫硬膜内髓外脊髓肿瘤的MRI诊断及手术治疗[J].畜牧与兽医,2018,50(1):129-132.ZHOU Cheng-yuan,WANG Yue-jun,YAO Da-wei,et al.The MRI diagnosis and surgical treatment of feline subdural tumor[J].Animal Husbandry and Veterinary Medicine,2018,50(1):129-132.(in Chinese)
[15] DIETEMANN J L,CORREIA B R,BOGORIN A,et al.Normal and abnormal meningeal enhancement:MRI features[J].Journal De Radiologie,2005,86(11):1659-1683.
[16] GUPTA RK,KATHURIA MK,PRADHAN S.Magnetization transfer MR imaging in CNS tuberculosis[J].American Society of Neuroradiology,1999,20(5):867-875.