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采用 MRI 和 31P MRS 技术对幼年和成年大鼠脑内内皮素-1 诱导的纹状体损伤进行特征描述。

Characterisation of endothelin-1-induced intrastriatal lesions within the juvenile and adult rat brain using MRI and 31P MRS.

机构信息

MRC Biochemical and Clinical Magnetic Resonance Unit, Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QU, United Kingdom,

出版信息

Transl Stroke Res. 2013 Jun;4(3):351-67. doi: 10.1007/s12975-013-0258-1. Epub 2013 Apr 18.

Abstract

Improved non-invasive magnetic resonance (MR) characterisation of in vivo models of focal ischaemic insults such as transient ischaemic attack (TIA) and perinatal arterial ischaemic stroke (AIS) may assist diagnosis, outcome prediction and treatment design. The classic middle cerebral artery occlusion (MCAO) model of ischaemic stroke is well documented in MR studies but generates extensive and complex lesions involving an acute inflammatory response and de-occlusion that immediately restores circulation. By contrast, intrastriatal microinjection of the potent vasoconstrictor, endothelin-1 (ET-1), induces a focal, reversible and low-flow ischaemia in the absence of a typical inflammatory response, which gradually restores blood flow over several hours and may be more relevant to TIA and AIS pathology. This study presents the first comprehensive longitudinal MR characterisation of the real-time anatomical [T1-weighted (T1-w)/T2-weighted (T2-w)], pathophysiological [apparent diffusion coefficient (ADC), cerebral blood volume, gadolinium contrast imaging of blood-brain barrier (BBB) integrity] and metabolic [phosphorus magnetic resonance spectroscopy (31P MRS)] evolution of a purely ischaemic ET-1-induced lesion within the juvenile and adult rat brain. ET-1-induced cytotoxic oedema was visualised on T2-w magnetic resonance imaging (MRI), inconsistent with the conventional notion that it cannot be detected using anatomical MRI. There was no immunohistochemical evidence of an acute inflammatory response or loss of BBB integrity, thus excluding a vasogenic oedema contribution to the pathology. Maximal T2-w intensity correlated with the lowest ADC value in both age groups, re-emphasising the purely ischaemic nature of the lesion and the absence of vasogenic oedema. Furthermore, extensive acute T1-w hypointensity was observed in the presence of cytotoxic oedema-induced T2-w changes, whereas other authors have shown that increased T1 values following MCAO reflect vasogenic oedema. Intriguingly, the lesion border exhibited hyperintensity on T2-w and ADC MRI at later time points, and the former may be a consequence of phagocytosis-induced fatty droplet deposition by macrophages detected immunohistochemically. In spite of a chronically reduced ADC, typically associated with ischaemia-induced energy failure, a 31P MRS-detectable reduction in the phosphocreatine (PCr) to gamma adenosine triphosphate (γATP) ratio was not observed at any time point in either age group, suggesting dissociation of tissue water diffusion and metabolic changes within the ET-1-induced lesion.

摘要

改善局灶性缺血性损伤(如短暂性脑缺血发作 [TIA] 和围产期动脉缺血性中风 [AIS])的体内模型的无创磁共振(MR)特征可能有助于诊断、预后预测和治疗设计。经典的大脑中动脉闭塞(MCAO)缺血性中风模型在 MR 研究中已有充分记录,但会产生广泛而复杂的病变,涉及急性炎症反应和再通,这会立即恢复循环。相比之下,内皮素-1(ET-1)的纹状体微注射会在没有典型炎症反应的情况下引起局灶性、可逆和低血流缺血,这种缺血会在数小时内逐渐恢复血流,与 TIA 和 AIS 病理更为相关。本研究首次全面纵向 MR 描绘了幼年和成年大鼠脑内纯缺血性 ET-1 诱导损伤的实时解剖学(T1 加权(T1-w)/T2 加权(T2-w))、病理生理学(表观扩散系数(ADC)、脑血容量、血脑屏障(BBB)完整性的钆对比成像)和代谢(31P 磁共振波谱(31P MRS))演变。T2-w MRI 可观察到 ET-1 诱导的细胞毒性水肿,这与传统观念(即解剖学 MRI 无法检测到)不一致。免疫组织化学未显示出急性炎症反应或 BBB 完整性丧失,因此排除了血管源性水肿对病理的贡献。在两个年龄组中,最大 T2-w 强度与 ADC 值最低相关,这再次强调了病变的纯缺血性和不存在血管源性水肿。此外,在细胞毒性水肿诱导的 T2-w 变化存在的情况下,观察到广泛的急性 T1-w 低信号,而其他作者已经表明,MCAO 后 T1 值增加反映了血管源性水肿。有趣的是,在损伤边界在稍后的时间点上在 T2-w 和 ADC MRI 上显示出高信号,前者可能是巨噬细胞吞噬作用引起的脂肪滴沉积的结果,这种沉积可通过免疫组织化学检测到。尽管存在典型的与缺血诱导能量衰竭相关的慢性 ADC 降低,但在两个年龄组的任何时间点都未观察到 31P MRS 可检测到的磷酸肌酸(PCr)与γ三磷酸腺苷(γATP)比值降低,这表明 ET-1 诱导的损伤内组织水扩散和代谢变化的分离。

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