兔肾缺血再灌注损伤的磁敏感加权成像应用初探

发布时间：2018-05-18 07:12

本文选题：肾脏 + 缺血再灌注　；参考：《苏州大学》2014年硕士论文

【摘要】：目的建立兔肾脏缺血再灌注（IRI）模型，探讨磁敏感加权成像（SWI）能否显示肾脏IRI活体早期和离体表现。材料和方法体重近似的新西兰大白兔24只，每只兔左肾结扎60min制作兔肾缺血再灌注模型，右肾作为对照不作处理，分别于制作缺血再灌注模型前、制作缺血再灌注模型后0.5h、24h及48h行活体T2WI和SWI扫描，每个时间点处死8只行离体肾脏T2WI、SWI扫描，利用SWI分析IRI模型皮髓质信号的变化及离体肾脏微血管数目，并与组织病理对照。结果制作缺血再灌注模型前正常兔肾T2WI呈内髓高信号、外髓明显低信号及皮质稍高信号三带分布，SWI外髓呈明显低信号，余部呈高信号；制作缺血再灌注模型后0.5h肾脏肿胀明显，皮质带变薄，内、外髓质增宽，T2WI外髓低信号带信号增高，内髓及皮质信号略升高，SWI上外髓信号减低呈更低信号；24h及48h皮髓质分界逐渐清楚，但SWI显示外髓信号仍高于结扎前的低信号，，并出现点状、条状出血灶。实验肾0.5h，24h、48h外髓外带点状出血灶的平均数目为0，2.5，6.75（P＜0.001）,三个时间点出血灶数目差别有统计学意义。离体0.5h、24h及48h显示IRI肾外髓带小血管平均数目分别为10.2，8.6，4.5（P＜0.001），三者之间的差别有统计学意义。对照肾血管数目分别为20.75，21.13，20.88，（P=0.91＞0.5）三者之间无统计学差异。结论 SWI能清楚显示活体肾脏，尤其是外髓的缺血再灌注损伤的早期信号改变，以及离体肾髓质小血管数目的变化，该技术可用来评估早期肾IRI变化。
[Abstract]:Purpose A model of renal ischemia-reperfusion (IRI) was established to investigate whether magnetic sensitivity weighted imaging (MRI) could show the early and in vitro manifestations of renal IRI in vivo. Materials and methods Twenty-four New Zealand white rabbits of similar weight were used to establish the model of renal ischemia-reperfusion by ligating the left kidney of each rabbit with 60min, and the right kidney was not treated as a control, respectively, before making the model of ischemia-reperfusion. T2WI and SWI scans were performed in vivo at 0.5 h, 24 h and 48 h after ischemia reperfusion. Eight isolated kidneys were sacrificed for T2WI SWI scan at each time point. The changes of medullary signal and the number of microvessels in isolated kidney of IRI model were analyzed by SWI, and compared with histopathological findings. Result The T2WI of normal rabbit kidney showed high signal intensity in inner pulp, low signal intensity in outer medulla and slightly high signal distribution in cortex, and high signal intensity in the rest of the kidney before the model was made, and the renal swelling was obvious at 0.5 h after ischemia reperfusion. The cortical zone thinned, the outer medullary thickened and the outer medullary hypointensity increased on T2WI, and the signal intensity of the inner and cortical increased slightly. The lower signal intensity of the external medulla on SWI showed a lower signal intensity, and the dividing line of the medulla was gradually clear at 24 h and 48 h, respectively. However, SWI showed that the signal intensity of the extramedullary pulp was still higher than that before ligation, and there were punctate and striped bleeding foci. The average number of extramedullary punctate bleeding foci in the experimental kidney at 0.5 h and 24 h and 48 h was 0 ~ 2.5g ~ 6.75 (P < 0.001), and there was significant difference in the number of bleeding foci at three time points. The average number of small vessels in the extrarenal medullary zone of IRI was 10.2 / 8.64.5g / h (P < 0.001), respectively, and the difference between them was statistically significant (P < 0.001). There was no significant difference in the number of renal vessels between the control group and the control group (20.75-21.13P > 0.91 > 0.5). Conclusion SWI can clearly demonstrate the early signal changes in the ischemic reperfusion injury of the living kidney, especially the extramedullary tissue, and the changes in the number of small vessels in the medulla of the isolated kidney. This technique can be used to evaluate the changes of renal IRI in the early stage.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R692

【参考文献】