中国神经再生研究(英文版) ›› 2014, Vol. 9 ›› Issue (9): 973-977.doi: 10.4103/1673-5374.133150

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

表观弥散系数值不能反映脑损伤后非损伤侧脑神经元的水肿

  

  • 收稿日期:2014-03-20 出版日期:2014-05-20 发布日期:2014-05-20
  • 基金资助:

    国家自然科学基金(81160181);河南省国际合作项目(Qiongke (2012) 65)

The apparent diffusion coefficient does not reflect cytotoxic edema on the uninjured side after traumatic brain injury

Hong Lu, Xiaoyan Lei   

  • Received:2014-03-20 Online:2014-05-20 Published:2014-05-20
  • Contact: Hong Lu, Department of Radiology, Affiliated Haikou Hospital, Xiangya School of Medicine, Central South University, Haikou 570208, Hainan Province, China, cqluh@sohu.com.
  • Supported by:

    This project was supported by the National Natural Science Foundation of China, No. 81160181; the International Cooperation Project of Hainan Province, No. Qiongke (2012) 65.

摘要:

脑创伤后损伤侧脑组织可相继出现血管源性水肿和神经细胞水肿,作者希望弥散张量成像检测中的表观弥散系数值可反映脑损伤后非损伤侧脑神经元的水肿。实验应用磁共振成像和病理学检测发现,大鼠损伤侧脑组织在损伤后1 h即出现血管源性水肿,3 h开始出现神经元细胞内水肿的混合性水肿,6 h水肿现象较明显,12-24 h继续加重并出现胶质增生;表观弥散系数值在损伤后1 h升高、6 h降低、12 h回升。非损伤侧脑组织在损伤后1 h未见异常,3 h出现神经元细胞水肿,6 h出现血管源性水肿,12-24 h神经元细胞水肿仍持续存在,但血管源性水肿有减轻趋势;表观弥散系数值在1-24 h均未见显著性差异。结果证实,脑创伤后损伤侧脑组织首先出现血管源性水肿,继之神经元细胞内水肿。非损伤脑组织侧的病理改变滞后于损伤侧,首先出现神经元细胞内水肿然后发生血管源性水肿,随时间延长血管源性水肿有缓解趋势。表观弥散系数值能反映脑创伤后损伤侧脑组织的水肿情况,但不能反映非损伤侧的水肿变化,而显示为“假性正常”现象。

关键词: 神经再生, 脑创伤, 脑挫伤, 病理, 血脑屏障, 磁共振成像, 表观扩散系数, 扩散加权成像, 脑水肿, 细胞水肿, 血管源性水肿, 国家自然科学基金

Abstract:

After traumatic brain injury, vasogenic and cytotoxic edema appear sequentially on the involved side. Neuroimaging investigations of edema on the injured side have employed apparent diffusion coefficient measurements in diffusion tensor imaging. We investigated the changes occurring on the injured and uninjured sides using diffusion tensor imaging/apparent diffusion coefficient and histological samples in rats. We found that, on the injured side, that vasogenic edema appeared at 1 hour and intracellular edema appeared at 3 hours. Mixed edema was observed at 6 hours, worsening until 12–24 hours post-injury. Simultaneously, microglial cells proliferated at the trauma site. Apparent diffusion coefficient values increased at 1 hour, decreased at 6 hours, and increased at 12 hours. The uninjured side showed no significant pathological change at 1 hour after injury. Cytotoxic edema appeared at 3 hours, and vasogenic edema was visible at 6 hours. Cytotoxic edema persisted, but vasogenic edema tended to decrease after 12–24 hours. Despite this complex edema pattern on the uninjured side with associated pathologic changes, no significant change in apparent diffusion coefficient values was detected over the first 24 hours. Apparent diffusion coefficient values accurately detected the changes on the injured side, but did not detect the changes on the uninjured side, giving a false-negative result.

Key words: nerve regeneration, brain injuries, blood-brain barrier, magnetic resonance imaging, apparent diffusion coefficient, intracranial edema, cytotoxic edema, vasogenic edema, pathology, NSFC grant, neural regeneration

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