Appleby C J, Towner R A
North Queensland Magnetic Resonance Centre, School Biomedical and Molecular Sciences, James Cook University, Townsville, Queensland, Australia 4811.
Pediatr Res. 2001 Oct;50(4):502-7. doi: 10.1203/00006450-200110000-00013.
Immaturity and oxygen toxicity have been implicated in the pathogenesis of the neonatal disease bronchopulmonary dysplasia. The present study aimed to investigate the use of magnetic resonance imaging (MRI) to assess hyperoxia-mediated lung injury in the term and premature neonate. Term (gestation, 22 d) and premature (21 d) rat pups were exposed to hyperoxia (>95%) or air for a 6-d period (n = 7) and assessed for lung damage by MRI. Pulmonary signal intensities of T1-weighted images were significantly increased in both hyperoxia-exposed term and premature neonates, relative to air-breathing controls (p < 0.01). T2-weighted MRI signal intensities were also greater in premature and term rat pups exposed to hyperoxia, but failed to reach significance (p > 0.05). Elevated MRI pulmonary signal intensities may have represented an increase in magnetic resonance-detectable free water, possibly indicating an increase in edema. Corresponding histologic evidence of lung injury was detected in both term and premature rat pups exposed to hyperoxia. Histologic samples indicated focal regions of alveolar hemorrhage, immune cell infiltration, edema, and collapse in both term and premature rat neonates exposed to hyperoxia. Alveolar air space was assessed (n = 5) by light microscopy within a 0.5 mm2 region of the superior left and inferior right pulmonary lobes of each treatment group. Alveolar area of the superior left lung lobe of the premature hyperoxia treatment group was significantly smaller than other treatment groups (p < 0.05). Reduced area for respiratory exchange was probably a result of observed focal areas of edema and collapse. MRI-detectable increases in lung signal intensity may have represented an increase in hyperoxia-induced pulmonary edema in the 6-d-old rat neonate. Increases in signal intensity correlated with the appearance of edema in pulmonary histologic samples. Premature delivery had a less defined effect on lung injury but possibly exacerbated hyperoxia-mediated pulmonary damage.
不成熟和氧中毒被认为与新生儿疾病支气管肺发育不良的发病机制有关。本研究旨在探讨使用磁共振成像(MRI)评估足月和早产新生儿高氧介导的肺损伤。将足月(胎龄22天)和早产(21天)的幼鼠暴露于高氧(>95%)或空气中6天(n = 7),并通过MRI评估肺损伤情况。与呼吸空气的对照组相比,暴露于高氧的足月和早产新生儿的T1加权图像的肺部信号强度均显著增加(p < 0.01)。暴露于高氧的早产和足月幼鼠的T2加权MRI信号强度也更高,但未达到显著水平(p > 0.05)。MRI肺部信号强度升高可能代表磁共振可检测的游离水增加,可能表明水肿增加。在暴露于高氧的足月和早产幼鼠中均检测到相应的肺损伤组织学证据。组织学样本显示,暴露于高氧的足月和早产新生大鼠均有肺泡出血、免疫细胞浸润、水肿和肺萎陷的局灶性区域。通过光学显微镜在每个治疗组的左上和右下肺叶的0.5 mm2区域内评估肺泡气腔(n = 5)。早产高氧治疗组左上肺叶的肺泡面积明显小于其他治疗组(p < 0.05)。呼吸交换面积减少可能是观察到的局灶性水肿和肺萎陷的结果。MRI检测到的肺信号强度增加可能代表6日龄新生大鼠高氧诱导的肺水肿增加。信号强度增加与肺组织学样本中水肿的出现相关。早产对肺损伤的影响不太明确,但可能会加重高氧介导的肺损伤。