Kastrup A, Neumann-Haefelin T, Moseley M E, de Crespigny A
Department of Radiology, Stanford University, California, USA.
J Cereb Blood Flow Metab. 2000 Dec;20(12):1636-47. doi: 10.1097/00004647-200012000-00003.
Spontaneous episodes of transient cell membrane depolarization (spreading depression [SD]) occur in the surroundings of experimental stroke lesions and are believed to contribute to infarct growth. Diffusion-weighted imaging (DWI) is capable of detecting the water shifts from extracellular to intracellular space associated with SD waves and ischemia, and can make in vivo measurements of these two features on a pixel-by-pixel basis with good temporal resolution. Using continuous high speed DWI with a temporal resolution of 12 seconds over a period of 3 hours, the in vivo contribution of spontaneous SDs to the development of ischemic tissue injury was examined in 8 rats using a thromboembolic stroke model. During the observation period, the initial lesion volume increased in 4 animals, remained unchanged in 1 animal, and decreased in 3 animals (most likely because of spontaneous clot lysis). Irrespective of the lesion evolution patterns, animals demonstrated 6.5 +/- 2.1 spontaneous SDs outside of the ischemic core. A time-to-peak analysis of apparent diffusion coefficient (ADC) changes for each SD wave demonstrated multidirectional propagation patterns from variable initiation sites. Maps of the time constants of ADC recovery, reflecting the local energy supply and cerebral blood flow, revealed prolonged recovery times in areas close to the ischemic core. However, repetitive SD episodes in the periinfarct tissue did not eventually lead to permanent ADC reductions. These results suggest that spontaneous SD waves do not necessarily contribute to the expansion of the ischemic lesion volume in this model.
短暂性细胞膜去极化的自发发作(扩散性抑制[SD])发生在实验性中风病灶周围,被认为会导致梗死灶扩大。扩散加权成像(DWI)能够检测与SD波和局部缺血相关的水从细胞外间隙向细胞内间隙的转移,并能以良好的时间分辨率在逐像素基础上对这两个特征进行体内测量。使用时间分辨率为12秒的连续高速DWI,在3小时内,利用血栓栓塞性中风模型在8只大鼠中研究了自发性SD对缺血性组织损伤发展的体内作用。在观察期内,4只动物的初始病灶体积增加,1只动物保持不变,3只动物减小(很可能是由于自发性血栓溶解)。无论病灶演变模式如何,动物在缺血核心区外均出现了6.5±2.1次自发性SD。对每个SD波的表观扩散系数(ADC)变化进行峰时分析,显示了从可变起始部位的多向传播模式。反映局部能量供应和脑血流量的ADC恢复时间常数图显示,在靠近缺血核心区的区域恢复时间延长。然而,梗死灶周围组织中反复出现的SD发作最终并未导致永久性ADC降低。这些结果表明,在该模型中,自发性SD波不一定会导致缺血性病灶体积扩大。