椎间盘造影中碘海醇剂量对大鼠椎间盘退行性变的影响

Effect of iohexol dosage on intervertebral disc degeneration during discography in rats

目的探讨椎间盘造影中造影剂碘海醇剂量对椎间盘退行性变的影响。方法以10只成年雄性SD大鼠的40个尾椎椎间盘(每只4个)为实验对象,分为空白组(Co6/Co7)、对照组(Co7/Co8)、常规剂量组(Co8/Co9,2μL碘海醇)和高剂量组(Co9/Co10,3μL碘海醇)。分别于椎间盘造影术后2周和4周使用X线检测椎间高度指数(DHI),使用MRI评估椎间盘信号;术后4周检测椎间盘含水量,并采用HE染色检测组织学变化。结果术后2周和4周时,与空白组相比,对照组DHI未见明显变化,常规剂量组和高剂量组DHI降低,且高剂量组比常规剂量组降低更为显著,差异均有统计学意义(P<0.05);对照组、常规剂量组和高剂量组椎间盘信号均降低,且剂量越大信号越低,差异均有统计学意义(P<0.05)。与空白组相比,对照组椎间盘含水量未见明显变化,常规剂量组和高剂量组椎间盘含水量降低,且高剂量组降低更为显著,差异均有统计学意义(P<0.05)。与空白组相比,对照组椎间盘组织学评分无明显变化,常规剂量组和高剂量组椎间盘组织学评分均增高,且剂量越大评分越高,差异均有统计学意义(P<0.05)。结论椎间盘造影时注入碘海醇可促进椎间盘退行性变,且呈剂量依赖性。在造影操作时应尽量减少造影剂的使用,以降低对椎间盘的影响。

Objective To investigate the effect of iohexol dose on disc degeneration in discography.Methods Forty coccygeal intervertebral discs of 10 adult male SD rats were divided into 4 groups:blank group(Co6/Co7),control group(Co7/Co8),conventional dose group(Co8/Co9,2 μL iohexol),and high dose group(Co9/Co10,3 μL iohexol).Roentgenography and MRI were used to detect disc height index(DHI) at 2 and 4 weeks after discography.The intervertebral disc tissue was obtained 4 weeks after discography,and the water content of the intervertebral disc was measured and the histological changes were detected by HE staining.Results At 2 and 4 weeks after discography,compared with the blank group,the DHI in the control group did not change significantly,the DHI in the conventional dose group and the high dose group decreased significantly,and the reduction in the high dose group was more significant,and the differences were statistically significant(P < 0.05);the signal of intervertebral disc decreased in the control group,the conventional dose group and the high dose group,and the larger the dose,the lower the signal,and the difference was statistically significant(P < 0.05).Compared with the blank group,there was no significant change in the water content of the intervertebral disc in the control group.The water content of the intervertebral disc in the conventional dose group and the high dose group decreased significantly,and the reduction in the high dose group was more significant,and the differences were statistically significant(P < 0.05).Compared with the blank group,there was no significant change in the histological score of intervertebral disc in the control group.The histological score in the conventional dose group and the high dose group decreased significantly,and the larger the dose,the higher the score,and the difference was statistically significant(P < 0.05).Conclusion During discography,the injection of iohexol can significantly increase disc degeneration,and it is positively correlated with the iohexol dose.During the discography,the use of iohexol should be minimized to reduce the disc degeneration.