Hwang In Sung, Kim Kyung Hyun, Sim Ki Bum
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea.
J Korean Neurosurg Soc. 2023 Jul;66(4):393-399. doi: 10.3340/jkns.2022.0144. Epub 2022 Dec 20.
Chiari II malformation (CM II) is still the main cause of severe morbidity and mortality in children with open neural tube defects (ONTDs). The goal of this study was to validate a CM II model in late-stage chick embryos with surgically induced ONTDs.
To make the chick embryo model of ONTD, their neural tubes were opened for a length of 5-6 somites at the thoracic level in Hamburger and Hamilton stage 18 chick embryos (n=150). They were reincubated in ovo. up to a total age of 17-21 days. A total of 19 embryos survived and were assigned to either the postoperative day (POD) 14-15 group (n=6) or the POD 17-18 group (n=13). Magnetic resonance imaging (MRI) and histopathologic findings of embryo heads with spinal ONTDs were compared with age-matched normal chick embryos.
The chick embryos with ONTDs demonstrated definite and constant structural changes, such as downward displacement of the cerebellum to just above the foramen magnum and narrow and small cerebrospinal fluid spaces in the crowded small posterior fossa. These morphologic features were more prominent in the POD 17-18 group than in the POD 14-15 group.
This is the first description of CM II with spinal ONTD in a late-stage chick embryo model with MRI and histopathological analysis. The morphological changes of the posterior fossa in this study mimic those of CM II associated with spinal ONTD in humans. This model will facilitate investigation of the pathogenesis of CM II.
Chiari II型畸形(CM II)仍是开放性神经管缺陷(ONTD)患儿严重发病和死亡的主要原因。本研究的目的是在手术诱导ONTD的晚期鸡胚中验证CM II模型。
为制作ONTD鸡胚模型,在Hamburger和Hamilton 18期鸡胚(n = 150)的胸段打开神经管5 - 6个体节长度。将它们在卵内再孵化至总年龄17 - 21天。共有19个胚胎存活,并被分配到术后第14 - 15天组(n = 6)或术后第17 - 18天组(n = 13)。将患有脊柱ONTD的胚胎头部的磁共振成像(MRI)和组织病理学结果与年龄匹配的正常鸡胚进行比较。
患有ONTD的鸡胚表现出明确且恒定的结构变化,如小脑向下移位至枕骨大孔上方,以及拥挤的小后颅窝中脑脊液间隙狭窄且小。这些形态学特征在术后第17 - 18天组比术后第14 - 15天组更明显。
这是首次在晚期鸡胚模型中通过MRI和组织病理学分析描述伴有脊柱ONTD的CM II。本研究中后颅窝的形态学变化与人类伴有脊柱ONTD的CM II相似。该模型将有助于研究CM II的发病机制。