数字减影血管造影评价股骨头坏死模型

Digital subtraction angiography evaluates the models of osteonecrosis of the femoral head

目的:用数字减影血管造影评价骨膜剥离加髓腔破坏法建立股骨头坏死动物模型的效果。方法:实验于2005-07/2006-01在武汉协和医院中心试验室完成。随机选用成年杂种狗12只,采用骨膜剥离加髓腔破坏法破坏实验动物左侧股骨头的血供,制造股骨头坏死模型,对侧为正常对照。分别于术后1,4,8,16周获取股骨头标本(每个时间点3只动物),制备病理切片进行苏木精-伊红染色观察组织学情况。实验第4周及第16周麻醉后MRI扫描观察股骨头坏死情况。实验动物术前及处死前麻醉后股动脉数字减影血管造影技术检测,比较手术前后股骨头局部的血液循环变化。结果:12只杂种狗均进入结果分析。①病理切片证实全部实验侧标本均出现不同程度股骨头坏死表现,且第16周股骨头标本呈轻度塌陷外观。②狗正常股骨头T1,T2像表现为中低信号影;实验第4周时,造模侧股骨头内表现出散在高信号;第16周时,这些高信号影进一步加大,头下区小片中低信号区。③数字减影血管造影图像显示手术后16周手术区局部出现多量新生血管从股骨颈、髓内等处再生长入有坏死的股骨头内的征象。结论:骨膜剥离加髓腔破坏法能成功建立股骨头坏死模型,且在该模型中存在坏死和重建并存的现象,符合股骨头坏死的病理变化,是一种比较理想的造模方式。

AIM： To evaluate the animal model of the osteonecrosis of the femoral head with digital subtraction angiography （DSA）. METHODS： The experiment was carried out in at the center laboratory of Wuhan Union Hospital from July 2005 to January 2006. Twelve mongrel adult dogs were selected, and the models of osteonecrosis of the femoral head were established by damaging the blood supply of left femoral head with periosteum dissection and marrow cavity destroy. Meanwhile, the right side served as control. Histological slices of femoral head were harvested on postoperative weeks 1, 4, 8, and 16 （3 dogs at each time point） for H-E staining. The osteonecrosis of femoral head was observed by magnetic resonance imaging （MRI） at 4 and 16 weeks after operation, Meanwhile, DSA was performed before operation and sacrificing the animals to compare the pre- and pro-operative blood flow surrounding femoral head. RESULTS： All 12 dogs entered the result analysis. ①Pathological sections suggested that all operated femoral heads showed osteonecrosis at different levels, moreover, obvious collapse appeared in the 16-week specimen. ②T1 and T2 images of normal femoral head were low to middle signal, while the scattered high signals were found in the operated femoral heads at the fourth week, which were enlarged at the sixteenth week. ③DSA images appealed that a plenty of new blood vessels grew into the necrotic femoral head through the neck of femur, and bone marrow. CONCLUSION： Dissecting periosteum and destroying marrow cavity is an ideal method to make the animal models of osteonecrosis of the femoral head, in which the necrosis and reconstruction co-exist, that is the pathological change of osteonecrosis of the femoral head.