Ueda F
Department of Radiology, Kanazawa University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1993 Jan 25;53(1):75-85.
To explain the mechanism of benign postoperative dural enhancement, the author made experimental model of rabbit's subdural hematoma and performed magnetic resonance (MR) imaging with gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA). On plain T1-weighted images, infused blood or red blood cells could not be detected immediately after surgery. On follow up plain T1-weighted images, the infused blood could be identified in only a case with 1 cc blood infusion. Marked dural enhancement could be seen immediately after surgery and continued three to fourteen days after 1 cc or 0.1 cc blood or 0.1 cc red blood cells infusion. To the contrary, no definite dural enhancement could be seen in the cases with plasma or saline infusion. Subdural red blood cells were required for dural enhancement immediately after surgery. Pathological findings revealed three types of reaction to infused blood: newly formed capillarization with fresh hemorrhage from the capillaries; subdural hematoma and no reaction. After vanishment of dural enhancement, pathological findings of the specimens were identical to that of normal dura. Dural enhancement may be induced by increased permeability of the dura associated with subdural hematoma and/or the extravasation of the contrast from newly formed capillaries.
为解释术后硬脑膜良性强化的机制,作者制作了兔硬膜下血肿实验模型,并使用钆喷酸葡胺(Gd-DTPA)进行磁共振(MR)成像。在平扫T1加权图像上,术后立即无法检测到注入的血液或红细胞。在随访平扫T1加权图像上,仅在注入1 cc血液的病例中可识别出注入的血液。在注入1 cc或0.1 cc血液或0.1 cc红细胞后,术后立即可见明显的硬脑膜强化,并持续三至十四天。相反,在注入血浆或盐水的病例中未见明确的硬脑膜强化。术后立即的硬脑膜强化需要硬膜下红细胞。病理结果显示对注入血液有三种反应类型:伴有来自毛细血管的新鲜出血的新形成的毛细血管化;硬膜下血肿和无反应。硬脑膜强化消失后,标本的病理结果与正常硬脑膜相同。硬脑膜强化可能是由与硬膜下血肿相关的硬脑膜通透性增加和/或来自新形成毛细血管的造影剂外渗引起的。