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目的 探讨建立大鼠脑血肿周围脑组织血流变化的CT灌注成像方法,并对其可行性进行研究。方法 雄性大鼠70只,采用随机数字抽样法将其分为注血组和对照组。分别将40μl新鲜自体血或生理盐水通过微量注射泵注入大鼠右侧尾状核制备脑出血模型。利用CT灌注成像对各组动物模型血肿周围脑组织血流变化进行观察,并与HE染色和红四氮唑(TTC)染色标本对照。通过计算机辅助CT脑灌注成像软件制作灌注CT参数图,并对血肿周围脑组织局部脑血流量(regionalcerebralbloodflow, rCBF)、局部脑血容量(regionalcerebralbloodvolume, rCBV)和平均通过时间(meantransittime, MTT)进行相对值(病侧/健侧)测量。结果 注血组血肿周围脑组织存在不同程度低灌注梯度,血肿周围脑组织局部脑血流量(rCBF)呈波动性改变,在注血后1hrCBF降至最低,随后逐渐回升、下降,分别于注血后6h和24h2次回升至峰值。TTC染色血肿呈黑褐色,血肿周围未见白色梗死区。病理学检查显示在出血灶与正常脑组织间存在过渡带即血肿周围区,周围区内组织疏松,细胞不同程度水肿,星形细胞肿胀,神经细胞变性,出血灶周边可见毛细血管增生及炎细胞浸润。对照组CT灌注成像、TTC染色和病理学检查均未见明显异常。结论 大鼠脑血肿周围脑组织血流变化的CT灌注成像方法稳定可
Objective To study the CT perfusion imaging method of establishing the cerebral blood flow around the cerebral hematoma in rats and to study its feasibility. Methods Seventy male rats were divided into two groups according to the random number sampling method: blood injection group and control group. Into the intracerebral hemorrhage model were prepared by injecting 40μl of fresh autologous blood or normal saline into the right caudate nucleus of rat through a microinjection pump. The CT perfusion imaging was used to observe the changes of blood flow in the perihematomal brain tissue in each group. The changes were compared with the HE staining and TTC staining. CT perfusion maps were generated by computer-assisted CT perfusion imaging software and relative brain tissue regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV) and mean transit time (MTT) were compared Value (diseased / contralateral) measurements. Results There were varying degrees of low perfusion gradient in the brain tissue around the hematoma in the injection group. The regional cerebral blood flow (rCBF) in the hematoma around the hematoma fluctuated. At 1 hr after the injection, the CBF decreased to the lowest level and then gradually rose and then decreased. After 6h and 24h2 back to the peak value. TTC stained hematoma dark brown, no white infarct around the hematoma area. Pathological examination revealed a transition zone between the hemorrhagic foci and normal brain tissue, ie, the area around the hematoma. The surrounding area was loosely organized with varying degrees of edema, astrocytic swelling and degeneration of the nerve cells. Capillary proliferation and inflammatory cells were observed around the hemorrhagic lesions infiltration. The control group CT perfusion imaging, TTC staining and pathological examination showed no significant abnormalities. Conclusion CT perfusion imaging of cerebral blood flow changes around the cerebral hematoma in rats may be stable