脊髓缺血性损伤的MRI与病理演变对照实验研究

Relating MRI Changes to Pathological Outcomes after Ischemic Stroke of Spinal Cord: An Experiment in Canines

目的 :研究脊髓缺血性损伤的MRI变化规律及其特征 ,及相应的病理机制。方法 :以家犬为实验模型 ,采用颈前路手术入路 ,损伤颈脊髓前动脉 ,进行肉眼、光镜观察。同时观察MRI异常信号演变过程和特征性表现。结果 :脊髓前动脉损伤后出现脊髓水肿、出血 ,运动神经元变性坏死等病理性变化。MRI异常信号出现在脊髓前动脉损伤节段的前 2 /3 ,多表现为一侧受累及或偏向一侧。结论 :脊髓缺血性损伤后的脊髓出血、水肿在MRI得到不同程度的反映。MRI能确定脊髓缺血性损伤的部位。

Objective: To investigate the rule of MRI changes and the related pathological mechanism. Methods: The model of spinal cord ischemia caused by cervical anterior spinal artery injury was established in canines. The pathology of corresponding segment of each cord was observed grossly and under light microscope. MRI outcome of spinal cord was observed dynamically post tischemia. Results: After cervical anterior spinal artery injury, the spinal cord underwent sequential phthological changes including hematomyelia, edema, axonal and motor neurons degeneration or necrosis, and demyelination. It was characteristic that the abnormal signal intensity of MRI on the cross section of the spinal cord was unilateral, and on the sagittal section in the anterior region of spinal cord. Conclusions: MRI can reveal abnormal signal intensity of spinal cord. These findings were related to edema and hematomyelia in this region. MRI could be clinically beneficial to diagnoze of spinal cord ischemia.