MR彌散成像聯(lián)合骨生化和病理對(duì)兔超早期激素性股骨頭壞死的研究
發(fā)布時(shí)間：2018-08-26 12:41
【摘要】：目的：采用彌散加權(quán)磁共振成像（diffusion weighted magnetic resonance imaging,DWI）技術(shù)聯(lián)合骨生化與病理組織學(xué)檢查對(duì)兔超早期激素性股骨頭壞死（osteonecrosis offemoral head,ONFH）模型進(jìn)行研究，進(jìn)一步探討DWI對(duì)超早期激素性O(shè)NFH的診斷價(jià)值。 方法：將40只健康成年中國大耳白兔隨機(jī)分為對(duì)照組和實(shí)驗(yàn)組，每組20只。ONFH造模：實(shí)驗(yàn)組兔經(jīng)耳緣靜脈首次注射馬血清10ml/kg一次，間隔2周后再次注入馬血清5ml/kg，Qd，連續(xù)2天；于首次注射馬血清后，間隔24小時(shí)肌肉注射甲基強(qiáng)的松龍4mg/kg，每周注射一次共8周；對(duì)照組在相同時(shí)間點(diǎn)用同樣的方法注射等量的生理鹽水。對(duì)照組和實(shí)驗(yàn)組分別于注射甲基強(qiáng)的松龍后2、4、6、8周周末各隨機(jī)5只兔行下列檢查：先抽耳緣靜脈血化驗(yàn)抗酒石酸酸性磷酸酶（tartrate-resistant acidphosphatase5b，，TRACP-5b）、骨鈣素（bone gla protein，BGP）；再行常規(guī)MRI及DWI檢查，獲得股骨頭負(fù)重區(qū)表觀彌散系數(shù)（apparent diffusion coefficient,ADC值）；最后處死動(dòng)物取雙側(cè)股骨頭標(biāo)本進(jìn)行病理組織學(xué)檢查。 結(jié)果：骨生化結(jié)果：與對(duì)照組比較：實(shí)驗(yàn)組4、6、8周TRACP-5b明顯升高、BGP明顯降低（P＜0.05），實(shí)驗(yàn)組2周TRACP-5b、BGP未見明顯變化（P＞0.05）；與實(shí)驗(yàn)組2周比較：實(shí)驗(yàn)組4、6、8周TRACP-5b明顯升高、BGP明顯降低（P＜0.05）；與實(shí)驗(yàn)組4周比較：實(shí)驗(yàn)組8周TRACP-5b明顯升高、BGP明顯降低（P＜0.05），實(shí)驗(yàn)組6周TRACP-5b、BGP未見明顯變化（P＞0.05）；與實(shí)驗(yàn)組6周比較:實(shí)驗(yàn)組8周TRACP-5b明顯升高、BGP明顯降低（P＜0.05）；對(duì)照組各時(shí)間點(diǎn)TRACP-5b、BGP值未見明顯變化（P＞0.05）；MRI結(jié)果：實(shí)驗(yàn)組和對(duì)照組各時(shí)間點(diǎn)常規(guī)MRI和DWI均未顯示異常；各時(shí)間點(diǎn)實(shí)驗(yàn)組ADC值明顯高于對(duì)照組；隨著時(shí)間點(diǎn)的延長(zhǎng)，實(shí)驗(yàn)組ADC值逐漸升高（P＜0.05）。病理結(jié)果：對(duì)照組2-8周切片均顯示軟骨細(xì)胞排列整齊，骨小梁完整、排列規(guī)則，骨細(xì)胞清晰，骨小梁周圍見成串排列的成骨細(xì)胞，可見散在的空骨陷窩，骨髓腔內(nèi)造血細(xì)胞豐富，脂肪細(xì)胞數(shù)量相對(duì)較少，大小均勻，形態(tài)正常；實(shí)驗(yàn)組2周時(shí)出現(xiàn)核邊聚，空骨陷窩較對(duì)照組增多；4周時(shí)表現(xiàn)為骨小梁萎縮、變細(xì)、排列紊亂，周圍成骨細(xì)胞數(shù)量明顯減少，空骨陷窩數(shù)增加明顯，脂肪細(xì)胞體積增大，部分融合；6-8周時(shí)可見骨小梁數(shù)量減少、粗大并斷裂，未見深染的骨細(xì)胞核，核周空暈變大，見大量空骨陷窩，骨小梁周圍見少量成骨細(xì)胞，骨髓區(qū)被增大的脂肪細(xì)胞所占據(jù)，部分融合。 結(jié)論：1.馬血清聯(lián)合少量激素制作的ONFH模型適用于激素性O(shè)NFH超早期研究； 2.TRACP-5b、BGP檢測(cè)對(duì)激素性O(shè)NFH超早期診斷具有參考價(jià)值；3.ADC值升高可反映超早期激素性O(shè)NFH的發(fā)生及發(fā)展，為臨床提供有價(jià)值的無創(chuàng)診斷信息。
[Abstract]:Objective: to study the ultraearly steroid-induced femoral head necrosis (osteonecrosis offemoral head,ONFH) model in rabbits with diffusion weighted magnetic resonance imaging (diffusion weighted magnetic resonance imaging,DWI) technique combined with bone biochemistry and histopathology, and to explore the value of DWI in the diagnosis of hyper-early steroid-induced ONFH. Methods: forty healthy adult Chinese white rabbits were randomly divided into control group and experimental group. Each group (n = 20) was treated with ONFH. The rabbits in the experimental group were injected with horse serum 10ml/kg via the auricular vein for the first time. After 2 weeks' interval, the serum of the horse was injected again with 5 ml / kg QD for 2 days. After the first injection of horse serum, 4 mg / kg methylprednisolone was injected intramuscularly every 24 hours, once a week for 8 weeks, and the control group was injected with the same amount of normal saline at the same time. Two weeks after injection of methylprednisolone, the control group and the experimental group were randomly divided into 5 rabbits at the end of 8 weeks. The following examinations were performed: first, the venous blood samples were drawn from the ear margin for tartrate-resistant acid phosphatase (tartrate-resistant acidphosphatase5b,TRACP-5b), osteocalcin (bone gla protein,BGP, and then routine MRI and DWI were performed. The apparent diffusion coefficient (apparent diffusion coefficient,ADC) of the femoral head was obtained. Finally, the specimens of bilateral femoral head were taken for histopathological examination. Results: compared with the control group, the TRACP-5b of the experimental group increased significantly at the 8th week (P < 0. 05), but the TRACP-5b,BGP of the experimental group did not change significantly at 2 weeks (P > 0. 05). Compared with the experimental group (2 weeks), the TRACP-5b of the experimental group increased significantly at the 8th week (P < 0. 05), the TRACP-5b of the experimental group significantly increased at the 8th week (P < 0. 05), and the TRACP-5b,BGP of the experimental group was not changed at the 6th week (P > 0. 05). Compared with the experimental group at 6 weeks, the TRACP-5b of the experimental group increased significantly at the 8th week (P < 0. 05), the TRACP-5b,BGP value of the control group did not change significantly at each time point (P > 0. 05). The results showed that the routine MRI and DWI were not abnormal at each time point in the experimental group and the control group. The ADC value of the experimental group was significantly higher than that of the control group at each time point, and with the extension of the time point, the ADC value of the experimental group gradually increased (P < 0. 05). Pathological results: in the control group, chondrocytes were arranged neatly, bone trabeculae were intact, bone cells were clear, bone trabeculae were arranged in a string of osteoblasts, and scattered empty bone lacunae were observed in the control group at 2-8 weeks. The hematopoietic cells in the medullary cavity were abundant, the number of adipocytes was relatively small, the size of adipocytes was uniform, and the morphology was normal. The number of osteoblasts decreased significantly, the number of empty bone lacunae increased significantly, and the volume of adipocytes increased. At 6-8 weeks after partial fusion, the number of bone trabeculae decreased, the bone trabeculae were coarse and broken, and the nucleus of bone without deep staining became larger. A large number of empty bone lacunae, a small number of osteoblasts around the trabecular bone, bone marrow area occupied by enlarged adipocytes, partial fusion. Conclusion 1. The ONFH model made by equine serum combined with a small amount of hormones is suitable for the study of hormone ONFH ultraearly. 2. The detection of TRACP-5 BGP has a reference value for the diagnosis of hormone ONFH. 3. The increase of ADC value can reflect the occurrence and development of hormone ONFH in the very early stage. To provide valuable non-invasive diagnostic information for clinical.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R681.8;R445.2
本文編號(hào)：2204899
[Abstract]:Objective: to study the ultraearly steroid-induced femoral head necrosis (osteonecrosis offemoral head,ONFH) model in rabbits with diffusion weighted magnetic resonance imaging (diffusion weighted magnetic resonance imaging,DWI) technique combined with bone biochemistry and histopathology, and to explore the value of DWI in the diagnosis of hyper-early steroid-induced ONFH. Methods: forty healthy adult Chinese white rabbits were randomly divided into control group and experimental group. Each group (n = 20) was treated with ONFH. The rabbits in the experimental group were injected with horse serum 10ml/kg via the auricular vein for the first time. After 2 weeks' interval, the serum of the horse was injected again with 5 ml / kg QD for 2 days. After the first injection of horse serum, 4 mg / kg methylprednisolone was injected intramuscularly every 24 hours, once a week for 8 weeks, and the control group was injected with the same amount of normal saline at the same time. Two weeks after injection of methylprednisolone, the control group and the experimental group were randomly divided into 5 rabbits at the end of 8 weeks. The following examinations were performed: first, the venous blood samples were drawn from the ear margin for tartrate-resistant acid phosphatase (tartrate-resistant acidphosphatase5b,TRACP-5b), osteocalcin (bone gla protein,BGP, and then routine MRI and DWI were performed. The apparent diffusion coefficient (apparent diffusion coefficient,ADC) of the femoral head was obtained. Finally, the specimens of bilateral femoral head were taken for histopathological examination. Results: compared with the control group, the TRACP-5b of the experimental group increased significantly at the 8th week (P < 0. 05), but the TRACP-5b,BGP of the experimental group did not change significantly at 2 weeks (P > 0. 05). Compared with the experimental group (2 weeks), the TRACP-5b of the experimental group increased significantly at the 8th week (P < 0. 05), the TRACP-5b of the experimental group significantly increased at the 8th week (P < 0. 05), and the TRACP-5b,BGP of the experimental group was not changed at the 6th week (P > 0. 05). Compared with the experimental group at 6 weeks, the TRACP-5b of the experimental group increased significantly at the 8th week (P < 0. 05), the TRACP-5b,BGP value of the control group did not change significantly at each time point (P > 0. 05). The results showed that the routine MRI and DWI were not abnormal at each time point in the experimental group and the control group. The ADC value of the experimental group was significantly higher than that of the control group at each time point, and with the extension of the time point, the ADC value of the experimental group gradually increased (P < 0. 05). Pathological results: in the control group, chondrocytes were arranged neatly, bone trabeculae were intact, bone cells were clear, bone trabeculae were arranged in a string of osteoblasts, and scattered empty bone lacunae were observed in the control group at 2-8 weeks. The hematopoietic cells in the medullary cavity were abundant, the number of adipocytes was relatively small, the size of adipocytes was uniform, and the morphology was normal. The number of osteoblasts decreased significantly, the number of empty bone lacunae increased significantly, and the volume of adipocytes increased. At 6-8 weeks after partial fusion, the number of bone trabeculae decreased, the bone trabeculae were coarse and broken, and the nucleus of bone without deep staining became larger. A large number of empty bone lacunae, a small number of osteoblasts around the trabecular bone, bone marrow area occupied by enlarged adipocytes, partial fusion. Conclusion 1. The ONFH model made by equine serum combined with a small amount of hormones is suitable for the study of hormone ONFH ultraearly. 2. The detection of TRACP-5 BGP has a reference value for the diagnosis of hormone ONFH. 3. The increase of ADC value can reflect the occurrence and development of hormone ONFH in the very early stage. To provide valuable non-invasive diagnostic information for clinical.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R681.8;R445.2
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