孕酮对大鼠创伤性脑水肿影响的DWI研究

Study on the effects of progesterone on traumatic brain edema in rats using DWI

目的应用磁共振弥散加权成像技术结合病理学改变分析孕酮对大鼠创伤性脑水肿的作用,探讨ADC值定量评价创伤性脑水肿的价值。方法将63只雄性SD大鼠随机分三组:正常对照组Normal control(NC组,n=7)、使用改良型Feeney模型致损伤组(TB组,n=28)、损伤+孕酮PROG治疗组(TP组,n=28),其中TP组和TB组分为3 h组、24 h组、1 w组、2 w组4个亚组,每个亚组各7只,致伤后行DWI扫描,测量各时间点创伤灶周水肿区的ADC值,采用统计学分析三组ADC值的差异,并与病理学检查对照。结果 (1)DWI结果 :3 h后,TB组及TP组水肿区ADC值开始逐渐升高,于24 h达到峰值,1 w及2 w逐渐降低。TB组与TP组ADC值比较在3 h、1 w及2 w时间点差异有统计学意义,P值分别为0.042、0.022、0.001。(2)病理表现:TB组及TP组3 h后细胞肿胀明显,细胞水肿,24 h出血及水肿达到高峰,二组比较差异无统计学意义。1 w后细胞水肿及出血较前减轻,部分可见含铁血黄素沉积,但TP组水肿及出血较TB组明显吸收。2 w后TP组较TB组水肿有所吸收。结论 DWI可以定量反映创伤性脑水肿的变化过程,ADC值是定量评估脑水肿的可靠影像学指标,孕酮能够减轻创伤性脑损伤所致的血管源性水肿。

Objective In this study, we analyzed the effect of progesterone on traumatic brain edema in rats using the ADC values measured from magnetic resonance diffusion weighted images（DWI）combined with pathological changes. Methods 63 male SD rats were randomly divided into three groups： normal control group（NC group, n = 7）, traumatic brain group（TB group, n = 28, modified Freeney mode）and the PROG treatment group（TP group, n = 28）. TP group and TB group were divided into 4 sub groups（3 h group, 24 h group, 1 week group, 2 week group）, with 7 rats in each sub group. DWI scan was performed after injury, and the ADC value of the edema area at each time point was measured by ADC image. The difference of ADC value between the three groups was statistically analyzed, comparing with pathological examination. Results（1） DWI results： in TB and TP group, the ADC value of the edema area began to increase gradually after 3 hours, reached the peak at 24 hours, and decreased gradually at the 1 week and the 2 weeks. The ADC values of TB group and TP group were significantly different at 3 hours, 1 weeks and 2 weeks. The P values were 0.042, 0.022 and 0.001, respectively.（P〈0.05）.（2） Pathological results： after 3 h, TB and TP group showed obvious swelling, cell edema. 24 h hemorrhage and edema reach peak. There was no significant difference between the two groups in 3 h and 24 h. After 1 week, the cell edema and bleeding were alleviated, and Heme deposition were observed. But the edema and hemorrhage in TP group were significantly higher. Compared with group TB, the edema of the TP group in the 2 week sub group was absorb. Conclusion The ADC values measured in DWI quantitatively reflects the changes of traumatic brain edema. ADC value is a reliable indicator of quantitative assessment of brain edema. Progesterone can reduce vascular edema caused by traumatic brain injury.