Hu Xiaojun, Diao Yuhang, Hao Zhenghao, Hao Mingyu, Xie Minghao, Rong Hongtao, Zhu Tao
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
Acta Neurol Belg. 2024 Jun;124(3):927-934. doi: 10.1007/s13760-024-02483-3. Epub 2024 Mar 2.
The mechanism behind SDAVF is still unclear. We discovered that the vessel wall of the SDAVF-DV occasionally showed enhancement in MRI, and this study assessed the relationship between the enhancement of the draining vein's wall and its histology.
For histopathologic analysis, 16 draining vein samples from 16 patients with SDAVF were included, 3 normal arteries and 3 normal veins were chosen as comparison. We assessed the imaging and microscopic characteristics of the draining veins in SDAVF patients. The former included the presence of significant enhancement of the wall of the draining vein in MRI, and the latter included the adherence, aggregation, infiltration of pro-inflammatory factors and inflammatory cells. Immuno-histochemical staining was performed using IL-1β, IL-8, TGF-β as well as MPO and MMP-9, and positive results were counted. Multiple logistic regression analysis was used to determine whether the infiltration of inflammatory cells was connected to vessel wall enhancement in the SDAVF-DV.
Infiltration of inflammatory cells was significantly higher in SDAVF-DV compared to normal vessels, 7 out of 16 patients significantly had enhancement of the vessel wall of SDAVF-DV, and logistic regression analysis showed that samples with more infiltration of inflammatory cells were more likely to show enhancement of the SDAVF-DV walls.
There was considerable inflammatory cells infiltration in SDAVF-DV, and this may explain why their vessel wall had such a significant enhancement in MRI.
硬脊膜动静脉瘘（SDAVF）背后的机制仍不清楚。我们发现SDAVF引流静脉（SDAVF-DV）的血管壁在磁共振成像（MRI）中偶尔会出现强化，本研究评估了引流静脉壁强化与其组织学之间的关系。
为进行组织病理学分析，纳入了16例SDAVF患者的16条引流静脉样本，选取3条正常动脉和3条正常静脉作为对照。我们评估了SDAVF患者引流静脉的影像学和微观特征。前者包括MRI中引流静脉壁是否存在显著强化，后者包括促炎因子和炎症细胞的黏附、聚集、浸润。使用白细胞介素-1β（IL-1β）、白细胞介素-8（IL-8）、转化生长因子-β（TGF-β）以及髓过氧化物酶（MPO）和基质金属蛋白酶-9（MMP-9）进行免疫组织化学染色，并统计阳性结果。采用多因素逻辑回归分析来确定炎症细胞浸润是否与SDAVF-DV的血管壁强化有关。
与正常血管相比，SDAVF-DV中炎症细胞浸润显著更高，16例患者中有7例SDAVF-DV的血管壁有明显强化，逻辑回归分析显示炎症细胞浸润较多的样本更有可能出现SDAVF-DV壁的强化。
SDAVF-DV中有大量炎症细胞浸润，这可能解释了为什么它们的血管壁在MRI中有如此显著的强化。
