Fonkalsrud E W, Sanchez M, Zerubavel R, Mahoney A
Surg Gynecol Obstet. 1977 Sep;145(3):395-400.
Acute and chronic morphologic changes in the endothelium and the media of canine femoral arteries following 4,000 roentgen given over a ten day period were evaluated by light and scanning electron microscopy. The endothelium showed evidence of moderate to severe acute injury within 48 hours after the course of radiation was completed, as evidenced by marked nuclear disruption with sloughing of entire cells in some areas and widespread patchy intimal fibrin deposition. Repopulation of the luminal surface with new cells forming an irregular and thickened surface became apparent within three weeks but was still incomplete at four months. The internal elastic membrane appeared to be preserved following radiation. The media evidenced minimal alteration during the first week subsequent to radiation, after which a progressive increase in cellularity and later fibrosis with some focal areas of necrosis and round cell infiltration occurred. The adventitia showed progressive hemorrhage and chronic inflammation. The results of this study suggest that radiation injury to the endothelium may be independent from injury to the remainder of the wall of the vessel. The morphologic alterations in the media and adventitia may be long lasting and perhaps permanent in contrast to the more acute changes with gradual repair in the endothelium. Arterial thrombosis is uncommon following radiation.
通过光学显微镜和扫描电子显微镜评估了犬股动脉在十天内接受4000伦琴辐射后内皮和中膜的急性和慢性形态学变化。在辐射疗程结束后的48小时内，内皮显示出中度至重度急性损伤的迹象，表现为明显的核破坏，一些区域出现整个细胞脱落，内膜广泛片状纤维蛋白沉积。三周内，管腔表面重新被新细胞填充，形成不规则且增厚的表面，但在四个月时仍未完全完成。辐射后内弹性膜似乎得以保留。辐射后的第一周，中膜变化极小，之后细胞数量逐渐增加，随后出现纤维化，伴有一些局灶性坏死和圆形细胞浸润。外膜出现进行性出血和慢性炎症。本研究结果表明，内皮的辐射损伤可能独立于血管壁其余部分的损伤。与内皮更急性的变化并逐渐修复相比，中膜和外膜的形态学改变可能持续时间长，甚至可能是永久性的。辐射后动脉血栓形成并不常见。
