Fajardo L F, Berthrong M
Pathol Annu. 1988;23 Pt 1:297-330.
The special radiation sensitivity of the vascular system is mainly linked to that of endothelial cells, which are perhaps the most radiation-vulnerable elements of mesenchymal tissues. Within the vascular tree, radiation injures most often capillaries, sinusoids, and small arteries, in that order. Lesions of veins are observed less often, but in certain tissues the veins are regularly damaged (e.g., intestine) or are the most affected structures (i.e., liver). Large arteries do suffer the least; however, when significant damage does occur in an elastic artery (e.g., thrombosis or rupture), it tends to be clinically significant and even fatal. Although not always demonstrable in human tissues, radiation vasculopathy generally is dose and time dependent. Like other radiation-induced lesions, the morphology in the vessels is not specific, but it is characteristic enough to be often recognizable. Vascular injury, especially by therapeutic radiation is not just a morphologic marker. It is a mediator of tissue damage; perhaps the most consistent pathogenetic mechanism in delayed radiation injury.
血管系统的特殊辐射敏感性主要与内皮细胞相关，内皮细胞可能是间充质组织中对辐射最敏感的成分。在血管树中，辐射最常损伤的依次是毛细血管、血窦和小动脉。静脉损伤较少见，但在某些组织中，静脉经常受损（如肠道）或为受影响最严重的结构（如肝脏）。大动脉受影响最小；然而，当弹性动脉发生严重损伤（如血栓形成或破裂）时，往往具有临床意义，甚至是致命的。虽然在人体组织中并不总是能证实，但放射性血管病通常与剂量和时间相关。与其他辐射诱导的损伤一样，血管中的形态并不具有特异性，但具有足够的特征性，常常可以识别。血管损伤，尤其是治疗性辐射造成的损伤，不仅仅是一种形态学标志。它是组织损伤的介质；也许是延迟性辐射损伤中最一致的发病机制。
