目的:探讨大鼠脑挫伤(TBI)后非损伤侧脑组织表观扩散系数(ADC )变化及其病理改变。方法选健康成年 Wistar 大鼠60只,制作中度脑挫伤模型,随机分为对照组及创伤组(1 h、3 h、6 h、12 h 及24 h 组),每组各10只,各时相点分别进行头部 MR-DWI 检查,测量损伤侧与镜像非损伤侧区的 ADC 值,取脑进行组织学观察、IgG 免疫组化染色半定量观察血脑屏障(BBB)的通透性,所得值进行统计学分析。结果对照组双侧脑组织结构及 DWI 未见异常,IgG 染色阴性。创伤组非损伤侧1 h 脑组织结构及DWI 未见异常,IgG 染色阴性。3 h 出现细胞内水肿,IgG 染色弱阳性。6 h 细胞内水肿加重,同时出现血管源性水肿,IgG 染色呈强阳性。12~24 h 细胞内水肿仍继续加重,而血管源性水肿有缓解趋势,IgG 染色减弱,并见小胶质细胞增生。非损伤侧 ADC 值与对照组比较差异无统计学意义(P >0.05)。损伤侧脑组织在1 h 即出现血管源性水肿,3 h 出现细胞内水肿,随时间2种水肿逐渐加重。ADC 值在1 h 升高、然后开始降低至6 h,6 h 后开始回升直至24 h,呈现“V”形变化趋势。结论当一侧脑挫伤时,非损伤侧的脑组织有相应的病理变化,在时间上滞后于损伤侧,首先出现的是细胞内水肿,然后发生血管源性水肿,随损伤时间延长血管源性水肿有缓解趋势,但 ADC 值无显著变化,呈现“假性正常”现象。
Objective This study was designed to investigate the correlation between the apparent diffusion coefficient(ADC)value and pathological change of the non-injured side brain tissue of traumatic brain injury(TBI)of rat.Methods Sixty healthy adult Wist-ar rats were randomly divided into two groups:the control or TBI groups.The TBI group was divided into five sub-groups according to the different time intervals:1,3,6,12,24 h(n = 10).The animal brain of each group was scanned with MR-DWI,and the ADC value of damaged areas and contralateral non-damaged areas were measured.After that the brains were taken out at different time points after TBI.The cerebral edema and blood-brain barrier(BBB)changes in structure were examined with an optical micros-copy and transmission electron microscopy,and the IgG content in the same tissues were determined by means of immunohistochem-istry.The data was analyzed with SPSS 13.0 statistical software.Results There was no signal abnormality on MR-DWI and tissue