弥漫性轴索损伤功能磁共振成像联合动态检查及病理机制的实验与临床研究

项目名称： 弥漫性轴索损伤功能磁共振成像联合动态检查及病理机制的实验与临床研究

项目编号： No.30870699

项目类型： 面上项目

立项/批准年度： 2009

项目学科： 电工技术

项目作者： 伍建林

作者单位： 大连医科大学

项目金额： 34万元

中文摘要： 创伤性脑损伤（TBI）是现代社会越来越常见的疾病和社会问题，其中弥漫性轴索损伤（DAI）尤为严重和棘手；本世纪以来，功能磁共振（fMRI）发展迅速，在TBI和DAI的诊断与治疗中显示出巨大潜力。本研究工作与结果：（1）DAI动物模型制作及病理学改变研究：通过自行研制兔脑DAI模型制作装置，对51只新西兰白兔成功建立轻重度DAI模型并进行系列MRI检查及病理学对照，神经元损伤、轴索损伤、轴浆外溢及周围小血管断裂等是主要形态学与免疫组化改变。(2)DAI兔脑模型的常规与功能MRI（DTI、SWI）系列与动态成像研究：发现DTI的FA与ADC值能早期定量评价DAI脑白质及轴索损伤的病理生理改变，尤其FA更加敏感，与损伤程度具很好相关性，ADC与FA值结合还有助于鉴别细胞毒与血管源性水肿；SWI不仅敏感发现微出血，且相位值可反应脑损伤后血氧代谢规律，有助于评估损伤程度及预后。（3）59例TBI/DAI进行89人次DTI及SWI动态研究：FA、ADC、PHASE等值与脑损伤程度、时间、GCS等均有良好相关性；并发现"异常血管征"及静脉血相位值是反映脑血氧代谢规律重要指标。

中文关键词： 弥漫性轴索损伤；创伤性脑损伤；功能磁共振成像；SWI

英文摘要： Traumatic brain injury (TBI) is an increasingly common disease and social issue in modern society, and diffuse axonal injury (DAI) is particularly serious and difficult to handle. In this century, functional MRI (fMRI) has developed rapidly and shown great potential in the diagnosis and treatment of TBI. Findings of our research work were listed below, 1) Establishment of DAI animal model and the pathological alterations post-trauma: Mild or severe DAI were randomly induced in 51 New Zealand rabbits by using a self-made device. The sequential MRI examinations and pathological study were employed following trauma. Morphological and immunohistochemical observations revealed that neuronal injury, axonal injury, extravasation of axoplasm, and rupture of small vessels were the major pathological alterations post-trauma. 2) Longitudinal MRI examinations of DAI rabbits: The DTI metrics, especially FA value, reflected the axonal injury quantitatively and exhibited significant correlations with injury severity . Changed ADC in association with FA changes could differentiate cytotoxic edema from vasogenic edema. SWI was extremely sensitive in the detection of microbleeding. Blood phase values available by SWI reflected the alterations of oxygen metabolism post-trauma, which could be used in the evaluation of injury severity and prognosis. 3) Longitudinal MRI study of 59 cases of TBI patients with a total 89 person-exams: FA, ADC and blood phase values all correlated well with the injury severity, injury duration, and GCS scores. '"Abnormal vessel signs" and blood phase values were two important indicators of cerebral oxygen metabolism.

英文关键词： diffuse axonal injury;traumatic brain injury;fuctional magnetic rasonance imaging;suscepibility weighted imaging(SWI)