The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ, 85013, USA.
Robert F. Spetzler Chair in Neuroscience, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ, 85013, USA.
Neurosurg Rev. 2024 Apr 25;47(1):190. doi: 10.1007/s10143-024-02363-7.
We assessed types of cadaveric head and brain tissue specimen preparations that are used in a high throughput neurosurgical research laboratory to determine optimal preparation methods for neurosurgical anatomical research, education, and training.
Cadaveric specimens (N = 112) prepared using different preservation and vascular injection methods were imaged, dissected, and graded by 11 neurosurgeons using a 21-point scale. We assessed the quality of tissue and preservation in both the anterior and posterior circulations. Tissue quality was evaluated using a 9-point magnetic resonance imaging (MRI) scale.
Formalin-fixed specimens yielded the highest scores for assessment (mean ± SD [17.0 ± 2.8]) vs. formalin-flushed (17.0 ± 3.6) and MRI (6.9 ± 2.0). Cadaver assessment and MRI scores were positively correlated (P < 0.001, R 0.60). Analysis showed significant associations between cadaver assessment scores and specific variables: nonformalin fixation (β = -3.3), preservation within ≤72 h of death (β = 1.8), and MRI quality score (β = 0.7). Formalin-fixed specimens exhibited greater hardness than formalin-flushed and nonformalin-fixed specimens (P ≤ 0.006). Neurosurgeons preferred formalin-flushed specimens injected with colored latex.
For better-quality specimens for neurosurgical education and training, formalin preservation within ≤72 h of death was preferable, as was injection with colored latex. Formalin-flushed specimens more closely resembled live brain parenchyma. Assessment scores were lower for preparation techniques performed > 72 h postmortem and for nonformalin preservation solutions. The positive correlation between cadaver assessment scores and our novel MRI score indicates that donation organizations and institutional buyers should incorporate MRI as a screening tool for the selection of high-quality specimens.
评估在高通量神经外科研究实验室中使用的尸头和脑组织标本制备类型，以确定用于神经外科研解剖研究、教育和培训的最佳制备方法。
使用不同的保存和血管内注射方法制备的尸体标本（N=112）进行成像、解剖，并由 11 名神经外科医生使用 21 分制进行评分。我们评估了前循环和后循环中组织和保存的质量。使用 9 分制磁共振成像（MRI）量表评估组织质量。
福尔马林固定标本的评估得分最高（平均值±标准差[17.0±2.8]），其次是福尔马林冲洗标本（17.0±3.6）和 MRI 标本（6.9±2.0）。尸体评估和 MRI 评分呈正相关（P<0.001，R 0.60）。分析显示，尸体评估得分与以下特定变量之间存在显著关联：非福尔马林固定（β=-3.3）、死亡后≤72 小时内保存（β=1.8）和 MRI 质量评分（β=0.7）。福尔马林固定标本比福尔马林冲洗和非福尔马林固定标本更硬（P≤0.006）。神经外科医生更喜欢用彩色乳胶注射的福尔马林冲洗标本。
为了获得更好质量的神经外科教育和培训标本，最好在死亡后≤72 小时内使用福尔马林保存，并使用彩色乳胶注射。福尔马林冲洗标本更接近活体脑组织。在死后>72 小时进行的制备技术和非福尔马林保存溶液的制备技术，标本质量较差。尸体评估得分与我们的新型 MRI 评分呈正相关，这表明捐赠组织和机构买家应将 MRI 作为筛选高质量标本的工具。
