Dynamics of Rabbit Brain Edema in Focal Lesion and Perilesion Area after Traumatic Brain Injury: A MRI Study
Dynamics of Rabbit Brain Edema in Focal Lesion and Perilesion Area after Traumatic Brain Injury: A MRI Study
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DOI：
10.1089/neu.2010.1510
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发表时间：
2012-09-01
影响因子：
4.2
通讯作者：
Li, Wen-Bin
中科院分区：
文献类型：
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作者：
Wei, Xiao-Er;Zhang, Yu-Zhen;Li, Wen-Bin
为了解兔创伤性脑损伤（TBI）后不同部位脑水肿的动态变化，采用动态磁共振增强成像（DCE-MRI）和弥散加权成像（DWI）监测兔体重下降致TBI后血脑屏障（BBB）通透性和细胞毒性脑水肿。采用K-trans和表观弥散系数（ADC）在病灶和病灶周围以及对侧区域量化血脑屏障通透性和脑水肿的动态。病灶区K-trans在tbi后3 h开始升高，3 d达到峰值，7 d和30 d逐渐下降，但仍高于假性损伤动物。ADC变化较大，3 h时略有升高，7 d时降至最低，30 d时达到峰值。在病灶周围区域，K-trans在第1天开始升高，3-7天达到峰值，30天恢复到对照水平。ADC在第1天呈上升趋势，此后呈持续上升趋势。在对侧区域，K-trans和ADC在任何时间点均未观察到变化。这些数据表明，不同类型的脑水肿主要发生在局灶性和局灶周围病变区域。其中细胞毒性水肿以局灶区为主，血管源性水肿以急性期局周区为主。此外，如果继发性损伤得不到控制，脑外伤后血脑屏障可能出现继发性开放。血脑屏障损伤可能是细胞毒性脑水肿的驱动力，可能是脑外伤干预的新靶点。
To understand the dynamics of brain edema in different areas after traumatic brain injury (TBI) in rabbit, we used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) to monitor blood-brain barrier (BBB) permeability and cytotoxic brain edema after weight drop-induced TBI in rabbit. The dynamics of BBB permeability and brain edema were quantified using K-trans and apparent diffusion coefficient (ADC) in the focal and perifocal lesion areas, as well as the area contralateral to the lesion. In the focal lesion area, K-trans began to increase at 3 h post-TBI, peaked at 3 days, and decreased gradually while remaining higher than sham injury animals at 7 and 30 days. ADC was more variable, increased slightly at 3 h, decreased to its lowest value at 7 days, then increased to a peak at 30 days. In the perifocal lesion area, K-trans began to increase at 1 day, peaked at 3-7 days, and returned to control level by 30 days. ADC showed a trend to increase at 1 day, followed by a continuous increase thereafter. In the contralateral area, no changes in K-trans and ADC were observed at any time-point. These data demonstrate that different types of brain edema predominate in the focal and perifocal lesion areas. Specifically cytotoxic edema was predominant in the focal lesion area while vasogenic edema predominated in the perifocal area in acute phase. Furthermore, secondary opening of the BBB after TBI may appear if secondary injury is not controlled. BBB damage may be a driving force for cytotoxic brain edema and could be a new target for TBI intervention.