Shi Haifeng, Li Ruokun, Qiang Jinwei, Li Ying, Wang Li, Sun Rongxun
Department of Radiology, Changzhou NO2 People's Hospital, Changzhou, Jiangsu 213000, China.
Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.
PLoS One. 2016 Jul 26;11(7):e0160102. doi: 10.1371/journal.pone.0160102. eCollection 2016.
To evaluate multi-slice computed tomography (CT) perfusion imaging (CTPI) for identifying microcirculatory dysfunction in small intestinal ischemia-reperfusion (IR) injury in a porcine model.
Fifty-two pigs were randomly divided into 4 groups: (1) the IR group (n = 24), where intestinal ischemia was induced by separating and clamping the superior mesenteric artery (SMA) for 2 h, followed by reperfusion for 1, 2, 3, and 4 h (IR-1h, IR-2h, IR-3h, and IR-4h; n = 6, respectively); (2) the sham-operated (SO) group (n = 20), where the SMA was separated without clamping and controlled at postoperative 3, 4, 5, and 6 h (SO-3h, SO-4h, SO-5h, and SO-6h; n = 5, respectively); (3) the ischemia group (n = 4), where the SMA was separated and clamped for 2 h, without reperfusion, and (4) baseline group (n = 4), an additional group that was not manipulated. Small intestinal CTPI was performed at corresponding time points and perfusion parameters were obtained. The distal ileum was resected to measure the concentrations of malondialdehyde (MDA) and superoxide dismutase (SOD) and for histopathological examination.
The perfusion parameters of the IR groups showed significant differences compared with the corresponding SO groups and the baseline group (before ischemia). The blood flow (BF), blood volume (BV), and permeability surface (PS) among the 4 IR groups were significantly different. BF and BV were significantly negatively correlated with MDA, and significantly positively correlated with SOD in the IR groups. Histopathologically, the effects of the 2-h ischemic loops were not significantly exacerbated by reperfusion.
CTPI can be a valuable tool for detecting microcirculatory dysfunction and for dynamic monitoring of small intestinal IR injury.
评估多层螺旋计算机断层扫描（CT）灌注成像（CTPI）在猪模型中识别小肠缺血再灌注（IR）损伤中微循环功能障碍的作用。
52头猪随机分为4组：（1）IR组（n = 24），通过分离并夹闭肠系膜上动脉（SMA）2小时诱导肠缺血，随后再灌注1、2、3和4小时（IR - 1h、IR - 2h、IR - 3h和IR - 4h；每组n = 6）；（2）假手术（SO）组（n = 20），分离SMA但不夹闭，并在术后3、4、5和6小时进行观察（SO - 3h、SO - 4h、SO - 5h和SO - 6h；每组n = 5）；（3）缺血组（n = 4），分离并夹闭SMA 2小时，不进行再灌注；（4）基线组（n = 4），为未进行任何操作的额外组。在相应时间点进行小肠CTPI检查并获取灌注参数。切除回肠末端以测量丙二醛（MDA）和超氧化物歧化酶（SOD）的浓度，并进行组织病理学检查。
IR组的灌注参数与相应的SO组和基线组（缺血前）相比有显著差异。4个IR组之间的血流量（BF）、血容量（BV）和通透表面积（PS）有显著差异。IR组中BF和BV与MDA显著负相关，与SOD显著正相关。组织病理学上，2小时缺血肠袢的影响在再灌注后未显著加重。
CTPI可成为检测微循环功能障碍和动态监测小肠IR损伤的有价值工具。
