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目的评价质子磁共振波谱(proton magnetic resonance spectroscopy,1HMRS)在家犬实验性脑缺血性损伤和动脉溶栓治疗中的应用价值。方法18条杂种成年家犬,自体血栓法建立局灶性脑缺血模型后随机分成未溶栓组(A组)和B1(1.5 h溶栓)、B3(3.5 h溶栓)、B6(6.5 h溶栓)、B9(9.5 h溶栓)、B12(12.5 h溶栓)6组,每组3条。每条动物均在栓塞后1、3、6、9、12、24 h行轴位DWI、MRS扫描。各组犬随机抽取1条于栓塞后24 h处死取脑做病理学检查。结果未溶栓组NAA,Cho及Cr峰在脑缺血后均表现为下降,其中NAA峰1~6 h内下降最迅速,Cho及Cr下降幅度不如NAA明显;Lac峰在脑缺血24 h内随梗死时间的延长而持续升高。溶栓组B1、B3、B6、B9组Lac峰升高程度比A组明显减小(P<0.05);NAA峰下降幅度减小(P<0.01);Lac/Cho值与24 h神经功能评分存在着高度的相关性。光镜下,未溶栓组出现大量神经元细胞坏死性改变,溶栓组神经元细胞形态改变程度轻,残存细胞数目明显增多。结论质子磁共振波谱能敏感地反映犬局灶性脑缺血后脑内代谢的动态演变过程,并可监测溶栓治疗效果。
Objective To evaluate the value of proton magnetic resonance spectroscopy (1HMRS) in the treatment of experimental cerebral ischemic injury and arterial thrombolysis in dogs. Methods Eighteen hybrid adult dogs were randomly divided into three groups: untreated group (group A), B1 (1.5 h thrombolysis), B3 (3.5 h thrombolysis) and B6 h thrombolysis), B9 (9.5 h thrombolysis), B12 (12.5 h thrombolysis) 6 groups of 3 each. Each animal was axial DWI, MRS scan 1,3,6,9,12,24 h after embolization. Each group of dogs were randomly selected 1 at 24 h after the eradication of the brain to do pathological examination. Results The NAA, Cho and Cr peaks of NAA, Cho and Cr decreased after cerebral ischemia in NA group, NAA peak decreased most rapidly in 1-6 h, Cho and Cr decreased less than NAA, With the extension of infarct time and continue to rise. The Lac peak in group B1, B3, B6 and B9 in thrombolysis group was significantly lower than that in group A (P <0.05), and the decrease of NAA peak was decreased (P <0.01) There is a high degree of relevance. Under the light microscope, a large number of neuronal cell necrosis changes occurred in the group without thrombolysis, the morphological changes of neuronal cells in thrombolysis group were light, and the number of residual cells increased obviously. Conclusions Proton magnetic resonance spectroscopy can sensitively reflect the dynamic process of brain metabolism after focal cerebral ischemia in dogs and can monitor the therapeutic effect of thrombolytic therapy.