Kamiryo T, Kassell N F, Thai Q A, Lopes M B, Lee K S, Steiner L
Department of Neurological Surgery, Virginia Neurological Institute, University of Virginia, Charlottesville, USA.
Acta Neurochir (Wien). 1996;138(4):451-9. doi: 10.1007/BF01420308.
Radiation-induced changes in the parietal cortex of Wistar rats were observed at various time points after gamma surgery. Maximum dosages of 50, 75, and 120 Gy were given at the iso-center of the radiation using a 4-mm collimator. Conventional histochemical and immunocytochemical analyses, and computer-assisted videomicroscopy were utilized to examine perfusion-fixed brain tissue. Irradiation at a dosage of 50 Gy elicited morphological changes of astrocytes in the parietal cortex at 3 months. Vasodilatation became obvious at 12 months; fibrin deposition was observed in the dilated capillary wall. Neither leakage of Evans Blue from the vasculature into the tissue nor necrosis was observed across the 12 month observation period. Irradiation at a dosage of 75 Gy resulted in morphological changes of astrocytes within 1 month. Dilatation of vessels and capillary thickening were observed at 3 months. Evans Blue leakage and necrosis were observed at 4 months after 75 Gy irradiation. At this time, the walls of arterioles became thickened by subintimal accumulation of fibrin and hyaline substance; this sometimes resulted in occlusion of the lumen. Significant hemispheric swelling was observed at 4 months. Irradiation at a dosage of 120 Gy elicited changes in astrocytic morphology within 3 days. Evans Blue leakage into the tissue was observed by 3 weeks. Vasodilation became marked at this time point and rarefaction was observed in the irradiated cortex. Necrosis was observed at 4 weeks, however, no significant swelling was observed. Taken together, these findings demonstrate time-dependent and dosage-dependent changes in normal cerebral tissue after Gamma Knife irradiation. These results provide a basis for gauging the impact of gamma surgery in regions of eloquent tissue. An enhanced understanding of the cellular responses to radiosurgery will contribute to developing and evaluating future applications for gamma surgery.
在伽马手术后的不同时间点观察了Wistar大鼠顶叶皮质的辐射诱导变化。使用4毫米准直器在辐射等中心给予最大剂量为50、75和120 Gy的辐射。利用传统组织化学和免疫细胞化学分析以及计算机辅助视频显微镜检查灌注固定的脑组织。50 Gy剂量的辐射在3个月时引起顶叶皮质星形胶质细胞的形态变化。12个月时血管扩张变得明显;在扩张的毛细血管壁中观察到纤维蛋白沉积。在12个月的观察期内,未观察到伊文思蓝从血管系统渗漏到组织中或坏死现象。75 Gy剂量的辐射在1个月内导致星形胶质细胞形态变化。3个月时观察到血管扩张和毛细血管增厚。75 Gy辐射后4个月观察到伊文思蓝渗漏和坏死。此时,小动脉壁因内膜下纤维蛋白和透明质物质积聚而增厚;这有时导致管腔闭塞。4个月时观察到明显的半球肿胀。120 Gy剂量的辐射在3天内引起星形胶质细胞形态变化。3周时观察到伊文思蓝渗漏到组织中。此时血管扩张变得明显,在受辐射的皮质中观察到稀疏现象。4周时观察到坏死,但未观察到明显肿胀。综上所述,这些发现表明伽马刀照射后正常脑组织存在时间依赖性和剂量依赖性变化。这些结果为评估伽马手术在明确组织区域的影响提供了依据。对放射外科手术细胞反应的深入了解将有助于开发和评估伽马手术的未来应用。