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目的 :分析磁共振扩散张量成像(diffusion tensor imaging,DTI)的参数表观扩散系数(apparent diffusion coefficient,ADC)值、各向异性分数(fractional anisotropy,FA)值与血小板活化因子(platelet activating factor,PAF)含量的相关性,探讨DTI对急性脊髓损伤的诊断价值。方法:采用12只中国大耳白兔,随机抽取6只作为实验组,另6只作为对照组。实验组切除T10椎板,采用Allen′s打击法制成急性脊髓损伤模型;对照组仅切开背部肌肉,暴露脊膜,不损伤脊髓。两组兔在造模后1d、3d、5d、7d行MRI平扫、DTI扫描,并测定股静脉血及脑脊液PAF含量,用Neuro 3D软件在FA图及ADC图上测量FA值及ADC值,对实验组的FA值及ADC值与PAF含量进行Pearson相关分析。结果 :与对照组比较,实验组各时间点ADC值明显升高,FA值明显降低(P<0.01)。随着时间点的推移,实验组ADC值逐渐升高,FA值逐渐降低(P<0.01),对照组各时间点ADC值、FA值未见明显变化(P>0.05)。实验组血浆及脑脊液PAF含量较对照组明显增高(P<0.01);实验组血浆及脑脊液PAF含量在造模后1d、3d、5d逐渐升高(P<0.01),7d降低(P<0.01);对照组各时间点PAF值未见明显变化(P>0.05)。实验组造模后1d、3d、5d血浆及脑脊液PAF值与ADC值呈明显正相关,7d呈负相关(|r|>0.8,P<0.05);与FA值1d、3d、5d呈明显负相关,7d呈正相关(|r|>0.8,P<0.05)。结论:ADC值、FA值与PAF含量具有良好的相关性,DTI参数能反映脊髓继发性损伤的发生和发展过程。
Objective: To analyze the parameters of diffusion tensor imaging (DTI), apparent diffusion coefficient (ADC), fractional anisotropy (FA) and platelet activation factor , PAF) content in patients with acute spinal cord injury DTI diagnostic value. Methods: Twelve Chinese white rabbits were randomly divided into experimental group (n = 6) and control group (n = 6). In the experimental group, T10 laminectomy was performed and the model of acute spinal cord injury was made by Allen’s strike method. In the control group, only the dorsal muscle was uncovered and the spinal cord was exposed without damaging the spinal cord. The levels of PAF in femoral venous blood and cerebrospinal fluid were measured by MRI and DTI scan on the 1st, 3rd, 5th, 7th day after model establishment. The FA and ADC values were measured by Neuro 3D software on FA and ADC maps. Pearson correlation analysis of FA value, ADC value and PAF content in the experimental group was carried out. Results: Compared with the control group, the ADC value of the experimental group increased significantly at each time point, FA value decreased significantly (P <0.01). With the passage of time, the ADC value of the experimental group gradually increased and the FA value decreased gradually (P <0.01). There was no significant change in ADC value and FA value in the control group at each time point (P> 0.05). The content of PAF in plasma and cerebrospinal fluid in experimental group was significantly higher than that in control group (P <0.01). PAF content in plasma and cerebrospinal fluid of experimental group increased gradually at 1d, 3d, 5d (P <0.01) There was no significant change of PAF in control group at all time points (P> 0.05). PAF in plasma and cerebrospinal fluid of the experimental group was positively correlated with ADC value at 1d, 3d and 5d, and negatively correlated at 7d (| r |> 0.8, P <0.05) Correlation, 7d was positively correlated (| r |> 0.8, P <0.05). Conclusion: There is a good correlation between ADC value and FA value and PAF content. DTI parameters can reflect the occurrence and development of secondary spinal cord injury.