本文選題：腎臟 + 缺血再灌注�。� 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：目的 建立兔腎臟缺血再灌注（IRI）模型，探討磁敏感加權(quán)成像（SWI）能否顯示腎臟IRI活體早期和離體表現(xiàn)。 材料和方法 體重近似的新西蘭大白兔24只，每只兔左腎結(jié)扎60min制作兔腎缺血再灌注模型，右腎作為對照不作處理，分別于制作缺血再灌注模型前、制作缺血再灌注模型后0.5h、24h及48h行活體T2WI和SWI掃描，每個時間點處死8只行離體腎臟T2WI、SWI掃描，利用SWI分析IRI模型皮髓質(zhì)信號的變化及離體腎臟微血管數(shù)目，并與組織病理對照。 結(jié)果 制作缺血再灌注模型前正常兔腎T2WI呈內(nèi)髓高信號、外髓明顯低信號及皮質(zhì)稍高信號三帶分布，SWI外髓呈明顯低信號，余部呈高信號；制作缺血再灌注模型后0.5h腎臟腫脹明顯，皮質(zhì)帶變薄，內(nèi)、外髓質(zhì)增寬，T2WI外髓低信號帶信號增高，內(nèi)髓及皮質(zhì)信號略升高，SWI上外髓信號減低呈更低信號；24h及48h皮髓質(zhì)分界逐漸清楚，但SWI顯示外髓信號仍高于結(jié)扎前的低信號，，并出現(xiàn)點狀、條狀出血灶。實驗?zāi)I0.5h，24h、48h外髓外帶點狀出血灶的平均數(shù)目為0，2.5，6.75（P＜0.001）,三個時間點出血灶數(shù)目差別有統(tǒng)計學(xué)意義。離體0.5h、24h及48h顯示IRI腎外髓帶小血管平均數(shù)目分別為10.2，8.6，4.5（P＜0.001），三者之間的差別有統(tǒng)計學(xué)意義。對照腎血管數(shù)目分別為20.75，21.13，20.88，（P=0.91＞0.5）三者之間無統(tǒng)計學(xué)差異。 結(jié)論 SWI能清楚顯示活體腎臟，尤其是外髓的缺血再灌注損傷的早期信號改變，以及離體腎髓質(zhì)小血管數(shù)目的變化，該技術(shù)可用來評估早期腎IRI變化。
[Abstract]:Purpose A model of renal ischemia-reperfusion (IRI) was established to investigate whether magnetic sensitivity weighted imaging (MRI) could show the early and in vitro manifestations of renal IRI in vivo. Materials and methods Twenty-four New Zealand white rabbits of similar weight were used to establish the model of renal ischemia-reperfusion by ligating the left kidney of each rabbit with 60min, and the right kidney was not treated as a control, respectively, before making the model of ischemia-reperfusion. T2WI and SWI scans were performed in vivo at 0.5 h, 24 h and 48 h after ischemia reperfusion. Eight isolated kidneys were sacrificed for T2WI SWI scan at each time point. The changes of medullary signal and the number of microvessels in isolated kidney of IRI model were analyzed by SWI, and compared with histopathological findings. Result The T2WI of normal rabbit kidney showed high signal intensity in inner pulp, low signal intensity in outer medulla and slightly high signal distribution in cortex, and high signal intensity in the rest of the kidney before the model was made, and the renal swelling was obvious at 0.5 h after ischemia reperfusion. The cortical zone thinned, the outer medullary thickened and the outer medullary hypointensity increased on T2WI, and the signal intensity of the inner and cortical increased slightly. The lower signal intensity of the external medulla on SWI showed a lower signal intensity, and the dividing line of the medulla was gradually clear at 24 h and 48 h, respectively. However, SWI showed that the signal intensity of the extramedullary pulp was still higher than that before ligation, and there were punctate and striped bleeding foci. The average number of extramedullary punctate bleeding foci in the experimental kidney at 0.5 h and 24 h and 48 h was 0 ~ 2.5g ~ 6.75 (P < 0.001), and there was significant difference in the number of bleeding foci at three time points. The average number of small vessels in the extrarenal medullary zone of IRI was 10.2 / 8.64.5g / h (P < 0.001), respectively, and the difference between them was statistically significant (P < 0.001). There was no significant difference in the number of renal vessels between the control group and the control group (20.75-21.13P > 0.91 > 0.5). Conclusion SWI can clearly demonstrate the early signal changes in the ischemic reperfusion injury of the living kidney, especially the extramedullary tissue, and the changes in the number of small vessels in the medulla of the isolated kidney. This technique can be used to evaluate the changes of renal IRI in the early stage.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.2;R692

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