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目的探讨3.0 T MRI弥散张量成像(diffusion tensor imaging,DTI)各向异性系数(fractional anisotropy,FA)在兔急性缺血性脑卒中出血性转化(hemorrhagic transformation,HT)预测中的价值。方法新西兰大白兔43只,随机分为手术组(33只)和假手术组(10只),手术组采用自体血栓法制备急性缺血性脑卒中模型,假手术组应用生理盐水代替自体血栓;手术组于模型制备成功后4 h应用尿激酶行静脉溶栓治疗,假手术组不作处理。2组分别于造模后3 h及溶栓治疗后2、12及24 h行DTI及MRI磁敏感加权成像(susceptibility weighted imaging,SWI)检查,依据末次SWI扫描是否发现缺血区域内低信号将手术组分为HT组(8只)和无HT组(25只),比较各组不同时间点FA值差异。结果假手术组术后均无行为障碍,MRI均未见异常;手术组麻醉苏醒后出现不同程度行为障碍;HT组造模后3 h及溶栓治疗后2、12及24 h FA值(0.143±0.017、0.126±0.018、0.136±0.017、0.141±0.017)低于无HT组(0.403±0.070、0.246±0.037、0.217±0.037、0.202±0.035)和假手术组(0.429±0.066、0.428±0.069 0.431±0.066、0.433±0.070)(P<0.05);无HT组溶栓后2、12及24h FA值低于假手术组(P<0.05),造模后3 h FA值与假手术组差异无统计学意义(P>0.05)。结论兔急性脑缺血性脑卒中后发生HT可能与FA值降低有关。
Objective To investigate the value of 3.0 T MRI diffusion tensor imaging (DTI) fractional anisotropy (FA) in the prediction of hemorrhagic transformation (HT) in acute ischemic stroke in rabbits. Methods 43 New Zealand white rabbits were randomly divided into operation group (n = 33) and sham operation group (n = 10). The model of acute ischemic stroke was established by autologous thrombosis in the operation group and saline was used instead of autologous thrombus in the sham operation group. In the operation group, urokinase was given intravenously thrombolytic therapy 4 h after successful model preparation, and the sham operation group was not treated. Two groups were examined by DTI and MRI with susceptibility weighted imaging (SWI) at 3 h after thrombolysis and at 2, 12 and 24 h after thrombolysis. Whether the low signal in the ischemic region was found based on the last SWI scan The operative components were HT group (n = 8) and no HT group (n = 25). The differences in FA values between different groups at different time points were compared. Results There were no behavioral disturbances in the sham operation group and no abnormality in MRI. Different degrees of behavioral disorders occurred in the operation group after anesthesia awakening. In the HT group, the FA values at 3 h and 2, 12 and 24 h after thrombolysis (0.143 ± 0.017,0.126 ± 0.018,0.136 ± 0.017,0.141 ± 0.017) were lower than those in the non-HT group (0.403 ± 0.070,0.246 ± 0.037,0.217 ± 0.037,0.202 ± 0.035) and sham-operated group (0.429 ± 0.066,0.428 ± 0.069 0.431 ± 0.066,0.433 ± 0.070) (P <0.05). The FA values at 2, 12 and 24 h after thrombolysis in HT-free group were lower than those in sham-operated group (P <0.05) Statistical significance (P> 0.05). Conclusion The incidence of HT after acute cerebral ischemic stroke may be related to the decrease of FA value.