南方医科大学学报 ›› 2005, Vol. 25 ›› Issue (04): 444-446.

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缺血性脑梗塞CT表现与梗塞后神经细胞凋亡及坏死的相关性

冯长征1, 李扬彬2, 谭理连2, 孙卫文3   

  1. 1. 广东省妇幼保健院放射科, 广东, 广州, 510010;
    2. 广州医学院第二附属医院放射科, 广东, 广州, 510260;
    3. 广州医学院神经科学研究所, 广东, 广州, 510120
  • 出版日期:2005-04-20 发布日期:2005-04-20
  • 基金资助:
    收稿日期:2004-6-22。
    基金项目:广州医学院科研基金(2000-GK35)
    作者简介:冯长征(1970-),男,硕士,主治医师,研究方向:神经影像学,电话:020-61118525

CT findings of ischemic infarction in relation to neuronal damage in rabbits

FENG Chang-zheng1, LI Yang-bin2, TAN Li-lian2, SUN Wei-wen3   

  1. 1. 广东省妇幼保健院放射科, 广东, 广州, 510010;
    2. 广州医学院第二附属医院放射科, 广东, 广州, 510260;
    3. 广州医学院神经科学研究所, 广东, 广州, 510120
  • Online:2005-04-20 Published:2005-04-20

摘要: 目的 探讨实验性缺血性脑梗塞早期CT表现与神经细胞损伤的相关性及与临床诊断、治疗、预后的关系。方法 将新西兰大白兔经颈总动脉注入PVA栓子栓塞大脑中动脉,在不同的时间点(2~36h)对兔脑进行CT扫描,并取脑组织经HE染色、Nissle染色、免疫组化(TUNEL法)进行观察。结果 CT分期Ⅰ期(脑梗塞后2~8h),神经细胞首先出现缺血改变,随后细胞周围出现水肿;基底节周围及大脑皮质可见少量TUNEL阳性细胞。CT分期Ⅱ期(梗塞后12~18h),以神经细胞溶解消失为主;基底节周围及大脑皮质可见较多TUNEL阳性细胞。CT分期Ⅲ期(梗塞后24~36h),脑水肿改变十分显著,基底节呈明显的坏死区,神经细胞坏死,结构消失,大脑皮质可见大量TUNEL阳性细胞。神经元具有凋亡及坏死的双重形态学特征。结论 缺血性脑梗塞后神经细胞损伤形态上有水肿、凋亡及坏死等多样性,CT扫描显示缺血性脑梗塞的进展与实际病理变化有高度相关性。

Abstract: Objective To explore the early changes in CT findings of ischemic infarction in relation to neuronal damage in rabbits. Methods Thirty-two rabbits were divided into control group and experiment groups and scanned with CT 2, 4, 8, 12, 18, 24, and 36 h after ischemic cerebral infarction induced by PVA embolization of the middle cerebral artery (MCA), respecti- vely. The brain specimen were stained with HE, Nissle and TUNEL techniques for pathological examination. Results In stage Ⅰ (2-8 h after MCA occlusion) by CT staging, the neurons exhibited ischemic change followed by cell edema. A small number of TUNEL-positive cells were found in the basal ganglia and cortex. In stage Ⅱ (12-18 h after MCA occlusion), neuronal swelling and lysis were observed with greater number of TUNEL-positive neurons in the basal ganglia and cortex. In stage Ⅲ (24-36 h after MCA obstruction), cerebral edema became obvious and ischemic cores were distinct, with numerous necrotic neurons seen and destruction of the cell structure. Numerous TUNEL-positive cells were seen in the ischemic penumbra and cortex. Conclusion The damaged neurons after ischemic cerebral infarction showed varied morphology including cell edema, apoptosis, necrosis, and necrosis-apoptosis continuum. CT manifestations are strongly associated with the progression of ischemia and the pathological changes.

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