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CT 灌注评估温度敏感型 p(N-异丙基丙烯酰胺-co-丁基甲基丙烯酸酯)纳米凝胶在兔肾动脉中的栓塞效果,并通过宏观检查确认。

Assessment of the embolization effect of temperature-sensitive p(N-isopropylacrylamide-co-butyl methylacrylate) nanogels in the rabbit renal artery by CT perfusion and confirmed by macroscopic examination.

机构信息

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, 518036, China.

出版信息

Sci Rep. 2021 Mar 1;11(1):4826. doi: 10.1038/s41598-021-84372-w.

Abstract

Transcatheter embolization is an important treatment method in clinical therapy, and vascular embolization material plays a key role in embolization. The temperature-sensitive p(N-isopropylacrylamide-co-butyl methylacrylate) (PIB) nanogel is a novel embolic agent. To evaluate the feasibility of the nanogel as a blood vessel embolization agent, we aimed to assess the effect of embolization with PIB nanogels in the rabbit renal artery by non-invasive computed tomography (CT) perfusion, macroscopic and histological examination. Ten healthy adult Japanese rabbits were used to implement RAE of PIB nanogels in their right kidneys. CT perfusion scans were performed pre- and post-treatment at various time-points (1, 4, 8, and 12 weeks). Two rabbits were euthanized and histologically examined at each time-point, and the remaining rabbits were euthanized at 12 weeks after embolization. The RAE efficacy of the nanogels was further confirmed by macroscopic and histological examination. The renal volume and renal blood flow (BF) of the right kidney were significantly decreased post-treatment compared with those pre-treatment (volume: pre, 9278 ± 1736 mm; post 1 week, 5155 ± 979 mm, P < 0.0001; post 4 weeks, 3952 ± 846 mm, P < 0.0001; post 8 weeks, 3226 ± 556 mm, P < 0.0001; post 12 weeks, 2064 ± 507 mm, P < 0.0001. BF: pre, 530.81 ± 51.50 ml/min/100 ml; post 1 week, 0 ml/min/100 ml, P < 0.0001; post 4 weeks, 0 ml/min/100 ml, P < 0.0001; post 8 weeks, 0 ml/min/100 ml, P < 0.0001; post 12 weeks, 0 ml/min/100 ml, P < 0.0001). No revascularization or collateral circulation was observed on histological examination during this period, and PIB nanogels were dispersed in all levels of the renal arteries. Twelve weeks after embolization, CT perfusion showed no BF in the right renal artery and renal tissue, a finding that was consistent with histological examination showing complete embolization of the right renal artery with a lack of formation of collateral vessels. The effect of embolization on PIB was adequate, with good dispersion and permanency, and could be evaluated by non-invasive and quantitative CT perfusion.

摘要

经导管栓塞术是临床治疗中的一种重要治疗方法,而血管栓塞材料在栓塞中起着关键作用。温敏性 p(N-异丙基丙烯酰胺-co-丁基甲基丙烯酸酯)(PIB)纳米凝胶是一种新型的栓塞剂。为了评估纳米凝胶作为血管栓塞剂的可行性,我们旨在通过非侵入性计算机断层扫描(CT)灌注、宏观和组织学检查来评估 PIB 纳米凝胶在兔肾动脉中的栓塞效果。10 只健康成年日本大耳白兔被用于在其右肾中实施 PIB 纳米凝胶的 RAE。在不同时间点(1、4、8 和 12 周)进行治疗前后的 CT 灌注扫描。每个时间点处死 2 只兔子进行组织学检查,其余兔子在栓塞后 12 周处死。通过宏观和组织学检查进一步证实了纳米凝胶的 RAE 效果。与治疗前相比,右肾的肾体积和肾血流量(BF)在治疗后明显下降(体积:治疗前,9278 ± 1736 mm;治疗后 1 周,5155 ± 979 mm,P < 0.0001;治疗后 4 周,3952 ± 846 mm,P < 0.0001;治疗后 8 周,3226 ± 556 mm,P < 0.0001;治疗后 12 周,2064 ± 507 mm,P < 0.0001。BF:治疗前,530.81 ± 51.50 ml/min/100 ml;治疗后 1 周,0 ml/min/100 ml,P < 0.0001;治疗后 4 周,0 ml/min/100 ml,P < 0.0001;治疗后 8 周,0 ml/min/100 ml,P < 0.0001;治疗后 12 周,0 ml/min/100 ml,P < 0.0001)。在此期间的组织学检查未观察到再血管化或侧支循环,PIB 纳米凝胶在各级肾动脉中均有分布。栓塞后 12 周,CT 灌注显示右肾动脉和肾组织无 BF,这一发现与组织学检查结果一致,即右肾动脉完全栓塞,无侧支血管形成。栓塞对 PIB 的效果是充分的,具有良好的分散性和永久性,可以通过非侵入性和定量 CT 灌注进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33bd/7921428/7a6e06faadad/41598_2021_84372_Fig1_HTML.jpg

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