Ren Xinping, Wang Yong, Wang Yi, Chen Hong, Chen Li, Liu Yi, Xu Chengshi
Department of Ultrasound, Huashan Hospital of Fudan University, Shanghai, China.
Department of Ultrasound, Huashan Hospital of Fudan University, Shanghai, China.
Clin Neurol Neurosurg. 2015 Apr;131:11-7. doi: 10.1016/j.clineuro.2015.01.011. Epub 2015 Jan 21.
To evaluate effect of thrombolytic therapy with rt-PA (recombinant tissue plasminogen activator) and transcranial color Doppler ultrasound (TCCS) combined with microbubbles on histology of brain tissue.
New Zealand rabbits were subjected to TCCS based thrombolytic therapy, in 8 groups depending on dose of rt-PA, exposure duration of TCCS and presence of attenuation by skull bone window, 2 animals/group: (1) skull+1/2 rt-PA+TCCS+MBs, 10 min, (2) skull+rt-PA+TCCS+MBs, 10 min, (3) skull+1/2 rt-PA+TCCS+MBs, 20 min, (4) skull+rt-PA+TCCS+MBs, 20 min, (5) skull+1/2 rt-PA+TCCS+MBs, 30 min, (6) skull+rt-PA+TCCS+MBs, 30 min, (7) 1/2 rt-PA+TCCS+MBs, 10 min, (8) 1/2 rt-PA+TCCS+MBs, 20 min. The brain tissues were harvested after therapies and submitted for microscopic, electronic microscope and immunohistochemical examination. The histological changes were scored.
TCCS caused exposure duration dependent brain tissue damage. With attenuation by bone window, TCCS based therapies for 10-20 min caused minimal tissue damage. However, significant tissue damage was observed upon TCCS for 30 min in presence of skull bone window, presenting as hemorrhage, misdistribution of organelles, demyelination of nerve fibers, and thinning of basement membrane in blood-brain barrier, which was milder than that after 20 min of exposure to TCCS in absence of bone window. Dose of rt-PA did not affect brain histology in all groups.
Short treatment of brain tissue with TCCS through a bone window is relative safe. And skull bone window protected brain tissue from TCCS induced damage.
评估重组组织型纤溶酶原激活剂（rt-PA）溶栓治疗及经颅彩色多普勒超声（TCCS）联合微泡对脑组织组织学的影响。
将新西兰兔进行基于TCCS的溶栓治疗，根据rt-PA剂量、TCCS暴露持续时间及颅骨骨窗是否存在衰减分为8组，每组2只动物：（1）颅骨+1/2 rt-PA+TCCS+微泡，10分钟；（2）颅骨+rt-PA+TCCS+微泡，10分钟；（3）颅骨+1/2 rt-PA+TCCS+微泡，20分钟；（4）颅骨+rt-PA+TCCS+微泡，20分钟；（5）颅骨+1/2 rt-PA+TCCS+微泡，30分钟；（6）颅骨+rt-PA+TCCS+微泡，30分钟；（7）1/2 rt-PA+TCCS+微泡，10分钟；（8）1/2 rt-PA+TCCS+微泡，20分钟。治疗后采集脑组织进行显微镜、电子显微镜及免疫组织化学检查。对组织学变化进行评分。
TCCS导致的脑组织损伤与暴露持续时间有关。在有骨窗衰减的情况下，基于TCCS的10 - 20分钟治疗引起的组织损伤最小。然而，在存在颅骨骨窗的情况下，TCCS治疗30分钟时观察到明显的组织损伤，表现为出血、细胞器分布异常、神经纤维脱髓鞘以及血脑屏障基底膜变薄，比无骨窗时TCCS暴露20分钟后的损伤要轻。rt-PA剂量在所有组中均未影响脑组织学。
通过骨窗对脑组织进行短时间的TCCS治疗相对安全。颅骨骨窗可保护脑组织免受TCCS诱导的损伤。
