MRI评估兔心肌梗死模型术后粘连

Experimental study of postoperative pericardial adhesions of myocardial infarction in rabbit models with MRI

目的:探讨MRI对兔心肌梗死模型术后心脏与周围组织粘连程度的评估价值。方法:25只日本长耳白兔,开胸结扎冠状动脉制备心肌梗死模型,随机分成两组,其中常规手术组11只,改性壳聚糖防粘连膜放置组14只。术后2～3个月分别行活体MRI检查和二次开胸手术,分别评估粘连程度,结果采用Wilcoxon秩和检验。结果:MRI评估常规手术组无粘连、轻度粘连、重度粘连分别为3、3和5只,防粘连膜放置组分别为4、9和1只。二次开胸手术评估常规手术组和防粘连膜放置组相应粘连程度分别为2、4、5只和5、7、2只。常规手术组和防粘连膜放置组心脏粘连程度有统计学差异(MRI与手术评估的P值分别为0.021和0.025)。MRI和二次开胸手术评估不同粘连程度相互吻合的数量分别为5、9和6只,两种评估方法的一致性检验Kappa值为0.69,P<0.001。结论:MRI与开胸手术评估心脏术后粘连程度具有较好的一致性。MRI可以很好地评估心脏术后粘连的程度。

Objective：To study the role of MRI in evaluating postoperative pericardial adhesion of myocardial infarc tion in rabbit models. Methods：Twenty-five Japanese white rabbits underwent open-chest surgery for coronary artery liga tion in order to prepare the myocardial infarction model were randomly divided into conventional operation group （n= 11） and placement of anti adhesion membrane group （n= 14）. In vivo MRI and second exploratory thoracotomy were performed respectively 2-3months after surgery to evaluate the degree of adhesion. The data were analyzed by Wilcoxon＇s rank test. The consistence between MRI and exploratory thoracotomy was checked. Results：The number of rabbits with no adhesion, mild adhesion and severe adhesion displayed on MRI were 3,3,5 cases respectively in conventional operation group and 4,9, 1 cases respectively in placement of anti-adhesion membrane group;the number of rabbits with no adhesion,mild adhesion and severe adhesion displayed during second exploratory thoracotomy were 2,4,5 cases in conventional operation group and 5,7,2 cases in placement of anti-adhesion membrane group with significant statistical differences （P： 0. 021 for MRI, and P=0. 025 for second operation）. The consistence of number of rabbits in evaluating the various degree of adhesion in MRI and second operation were 5,9,6 cases （ Kappa=0.69, P〈0.001 ）. Conclusions .. Magnetic resonance imaging assessment of pericardial adhesion was in good agreement with exploratory thoracotomy, MRI could be a good modality in evaluating adhe sion after cardiac surgery.