Bendszus Martin, Wessig Carsten, Schütz Ansgar, Horn Tanja, Kleinschnitz Christoph, Sommer Claudia, Misselwitz Bernd, Stoll Guido
Department of Neuroradiology, University of Würzburg, Josef-Schneider-Strasse 11, D-97080 Würzburg, Germany.
Ann Neurol. 2005 Mar;57(3):388-95. doi: 10.1002/ana.20404.
Nerve injury represents a major cause of disability. In the peripheral nervous system, nerves have the capacity to regrow but within weeks after injury, it is impossible to clarify whether proper regeneration is under way or is failing. In this experimental study, we report on a novel tool to assess nerve outgrowth in vivo. After systemic application, the novel gadolinium-based magnetic resonance (MR) contrast agent Gadofluorine M (Gf) selectively accumulated and persisted in nerve fibers undergoing Wallerian degeneration causing bright contrast on T1-weighted MR images. Gf enhancement on MR imaging was present already at 48 hours within the entire nerve segments undergoing Wallerian degeneration, and subsequently disappeared from proximal to distal parts in parallel to regrowth of nerve fibers. Most importantly, Gf enhancement persisted in nonregenerating, permanently transected nerves. Our novel Gf-based MR imaging methodology holds promise for clinical use to bridge the diagnostic gap between nerve injury and completed nerve regeneration, and to determine the necessity for neurolysis and engraftment if spontaneous regeneration is not successful.
神经损伤是致残的主要原因。在周围神经系统中，神经具有再生能力，但在损伤后的数周内，无法明确神经是否正在进行正常再生或再生失败。在本实验研究中，我们报告了一种评估体内神经生长的新工具。全身应用后，新型钆基磁共振（MR）造影剂钆弗塞胺M（Gf）选择性地积聚并持续存在于经历华勒氏变性的神经纤维中，在T1加权MR图像上产生明亮的对比。在经历华勒氏变性的整个神经节段内，Gf在MR成像上的强化在48小时时就已出现，随后随着神经纤维的再生从近端到远端逐渐消失。最重要的是，Gf强化在无法再生的永久性横断神经中持续存在。我们基于Gf的新型MR成像方法有望用于临床，以弥合神经损伤与完全神经再生之间的诊断差距，并在自发再生不成功时确定是否需要进行神经松解和移植。
