Nakagawa M, Matsumoto K, Higashi H, Furuta T, Ohmoto T
Department of Neurological Surgery, Okayama University Medical School.
Neurol Med Chir (Tokyo). 1994 Oct;34(10):668-75. doi: 10.2176/nmc.34.668.
The magnitude and time course of histological and neuroradiological changes due to interstitial hyperthermia in normal cerebral white matter were investigated in eight adult Japanese monkeys. A cooling system enveloping a 2450-MHz microwave antenna was inserted stereotactically into the brain under general anesthesia. A point located 5 mm away from the surface of the cooling system was used as the reference point (RP). Hyperthermia was given to maintain the RP at 43 degrees C for 60 minutes. Two animals were sacrificed under general anesthesia following the intravenous administration of Evans blue, immediately and 1, 3, and 7 days after treatment. After removing the brain, histological changes were investigated. Magnetic resonance (MR) imaging was performed at 1, 3, and 7 days after treatment. Evans blue extravasation was most prominent in the region heated to 43 degrees C or above immediately after treatment. MR imaging showed obvious enhancement in the region heated to 43 degrees C or above 1 day after treatment, related to the disruption of the blood-brain barrier (BBB) by hyperthermia. Three days after treatment, ring-like enhancement with a central low-intensity area was seen in the region heated to about 43 degrees C, caused by BBB disruption and slight neovascularization. One week after treatment, an enhanced ring was observed in the region heated to less then 43 degrees C which surrounded a low-intensity area. The enhancement seen 1 week after treatment was caused by prominent neovascularization. T2-weighted imaging showed a high-intensity area, caused by edema, most prominent 3 days after treatment. Thus chemotherapeutic agents should be given just before the end of hyperthermia.
在八只成年日本猕猴中，研究了正常脑白质间质热疗引起的组织学和神经放射学变化的程度及时间进程。在全身麻醉下，将包裹2450兆赫兹微波天线的冷却系统立体定向插入脑内。以距离冷却系统表面5毫米处的点作为参考点（RP）。进行热疗，使RP维持在43摄氏度60分钟。在静脉注射伊文思蓝后，于治疗后即刻、1天、3天和7天，在全身麻醉下处死两只动物。取出脑后，研究组织学变化。在治疗后1天、3天和7天进行磁共振（MR）成像。治疗后即刻，伊文思蓝外渗在加热至43摄氏度及以上的区域最为明显。MR成像显示治疗后1天，加热至43摄氏度及以上的区域有明显强化，这与热疗导致的血脑屏障（BBB）破坏有关。治疗后3天，在加热至约43摄氏度的区域可见中央低强度区的环状强化，这是由BBB破坏和轻微新生血管形成所致。治疗后1周，在加热至低于43摄氏度且围绕低强度区的区域观察到强化环。治疗后1周出现的强化是由显著的新生血管形成引起的。T2加权成像显示由水肿导致的高强度区，在治疗后3天最为明显。因此，化疗药物应在热疗即将结束前给予。
