Research on the feasibility of dynamic contrast-enhanced magnetic resonance imaging in assessing the microcirculatory perfusion of skeletal muscle in rabbit limbs in the early stage after high-voltage electric burns
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摘要:
目的 探讨动态对比增强磁共振成像（DCE-MRI）评估兔肢体高压电烧伤后早期骨骼肌微循环灌注的可行性。 方法 该研究为实验研究。取32只6~8个月龄雄性大耳白兔,采用随机数字表法将兔分为右下肢致高压电烧伤的电烧伤组（20只）及右下肢致假伤的对照组（12只）。伤后0.5、24.0、48.0、72.0 h,完成2组兔下肢轴位快速自旋回波T1加权成像、快速自旋回波T2加权成像及DCE-MRI检查,应用参考区域血流动力学模型获取损伤肢体骨骼肌血流灌注参数,包括容量转移常数Ktrans值、速率常数Kep值。取电烧伤组兔伤后0.5、24.0、48.0、72.0 h及对照组兔伤后0.5 h的骨骼肌组织,行免疫组织化学染色观察微血管情况并计算微血管密度（MVD）。分析电烧伤组兔伤后0.5~72.0 h骨骼肌组织Ktrans值、Kep值与MVD的相关性。电烧伤组样本数为5,对照组样本数为3。 结果 电烧伤组兔骨骼肌组织Ktrans值和Kep值均在伤后0.5~72.0 h呈先升高后降低的趋势,且在伤后24.0 h达到峰值。电烧伤组兔伤后0.5、24.0、48.0、72.0 h骨骼肌组织Ktrans值（t值分别为-15.77、-14.91、-40.35、-40.25,P<0.05）及伤后0.5、24.0、48.0 h骨骼肌组织Kep值（t值分别为-5.39、-6.82、-6.83,P<0.05）均明显高于对照组。对照组兔伤后0.5 h及电烧伤组兔伤后0.5、24.0、48.0、72.0 h骨骼肌组织中MVD分别为（24.7±3.5）、（21.8±2.2）、（40.8±9.1）、（16.4±2.4）、（9.8±0.8）根/mm2。电烧伤组兔伤后24.0 h骨骼肌组织中MVD明显高于对照组伤后0.5 h （t=2.89,P<0.05）,伤后48.0、72.0 h骨骼肌组织中MVD均明显低于对照组伤后0.5 h（t值分别为4.01、9.52,P<0.05）。电烧伤组兔伤后0.5~72.0 h骨骼肌组织中Ktrans值、Kep值均与MVD呈显著正相关（r值均为0.95,P<0.05）。 结论 DCE-MRI定量灌注参数Ktrans值及Kep值可有效反映兔肢体高压电烧伤后早期骨骼肌微循环灌注变化。 Abstract:Objective To explore the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing the microcirculatory perfusion of skeletal muscle in rabbit limbs in the early stage after high-voltage electric burns. Methods This study was an experimental study. Thirty-two male big ear white rabbits aged 6-8 months were assigned into electric burn group of 20 rabbits with high-voltage electric burns in the right lower limb and control group of 12 rabbits with sham injury in the right lower limb using the random number table method. At 0.5, 24.0, 48.0, and 72.0 h post injury, the lower limbs of rabbits in the two groups underwent axial fast spin echo T1-weighted imaging, fast spin echo T2-weighted imaging, and DCE-MRI examination. A reference region-based hemodynamic model was applied to obtain the blood perfusion parameters of skeletal muscle in the injured limbs, including the volume transfer constant Ktrans value and rate constant Kep value. The skeletal muscle tissue from the electric burn group of rabbits at 0.5, 24.0, 48.0, and 72.0 h post injury and the control group of rabbits at 0.5 h post injury was harvested for immunohistochemical staining to observe the microvascular changes and calculate the microvascular density (MVD). The correlation between the Ktrans and Kep values and the MVD of skeletal muscle tissue in electric burn group of rabbits at 0.5-72.0 h post injury was analyzed. The number of samples was 5 in the electric burn group, and the number of samples was 3 in the control burn group. Results From 0.5-72.0 h post injury, the Ktrans and Kep values in skeletal muscle tissue of electric burn group of rabbits exhibited the trends of increase first and decrease then, both of which reached peak values at 24.0 h post injury. The Ktrans values at 0.5, 24.0, 48.0, and 72.0 h post injury (with t values of -15.77, -14.91, -40.35, and -40.25, respectively, P<0.05) and the Kep values at 0.5, 24.0, and 48.0 h post injury (with t values of -5.39, -6.82, and -6.83, respectively, P<0.05) in skeletal muscle tissue in electric burn group of rabbits were significantly higher than those in control group. The MVD in skeletal muscle tissue in control group of rabbits at 0.5 h post injury and in electric burn group of rabbits at 0.5, 24.0, 48.0, and 72.0 h post injury was (24.7±3.5), (21.8±2.2), (40.8±9.1), (16.4±2.4), and (9.8±0.8) per mm², respectively. The MVD in skeletal muscle tissue in electric burn group of rabbits at 24.0 h post injury was significantly higher than that in control group at 0.5 h post injury (t=2.89, P<0.05), and the MVD in skeletal muscle tissue at 48.0 and 72.0 h post injury was significantly lower than that in control group at 0.5 h post injury (with t values of 4.01 and 9.52, respectively, P<0.05). The Ktrans and Kep values of skeletal muscle tissue in rabbits in electric burn group were significantly positively correlated with microvascular density at 0.5 to 72.0 h post injury (with both r values of 0.95, P<0.05). Conclusions The quantitative perfusion parameters Ktrans and Kep values of DCE-MRI can effectively reflect the microcirculatory perfusion changes of skeletal muscle in rabbit limbs in the early stage after high-voltage electric burns. -
Key words:
- Burns, electric /
- Magnetic resonance imaging /
- Muscle, skeletal /
- Microvessels /
- Microcirculation
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参考文献
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图 1 2组兔伤后24.0 h右下肢骨骼肌组织DCE-MRI检测情况。1A、1B、1C.分别为对照组增强快速自旋回波T1加权成像及Ktrans值、Kep值图像；1D、1E、1F.分别为电烧伤组增强快速自旋回波T1加权成像及Ktrans值、Kep值图像,图1E中Ktrans值和图1F中Kep值分别高于图1B、1C
注：电烧伤组兔右下肢致高压电烧伤,对照组兔右下肢致假伤；DCE-MRI为动态对比增强磁共振成像；1A和1D中红色区域为感兴趣区；1B、1C和1E、1F右侧的色柱为比色卡,可根据颜色大致判断灌注参数大小,越接近红色代表灌注参数越大
图 2 对照组兔伤后 0.5 h及电烧伤组兔伤后各时间点右下肢骨骼肌组织损伤情况 苏木精-伊红×200。2A.对照组伤后0.5 h,骨骼肌细胞结构完整、排列紧密；2B、2C、2D、2E.分别为电烧伤组伤后0.5、24.0、48.0、72.0 h,随着伤后时间的延长,骨骼肌纤维变性、坏死范围扩大,骨骼肌纤维周围炎症细胞数量增多
注：电烧伤组兔右下肢致高压电烧伤,对照组兔右下肢致假伤
图 3 对照组兔伤后 0.5 h及电烧伤组兔伤后各时间点右下肢骨骼肌组织中微血管情况 辣根过氧化物酶-二氨基联苯胺×200。3A.对照组伤后0.5 h；3B、3C、3D、3E.分别为电烧伤组伤后0.5、24.0、48.0、72.0 h,图3C微血管数量多于图3B、3D、3E
注：电烧伤组兔右下肢致高压电烧伤,对照组兔右下肢致假伤；血管内皮细胞染色为棕色,细胞核染色为蓝色
Table 1. 2组兔伤后各时间点右下肢骨骼肌组织DCE-MRI定量灌注参数比较(min-1,
组别与指标 样本数 0.5 h 24.0 h 48.0 h 72.0 h 电烧伤组 5 Ktrans值 5.779±0.558 8.255±0.861 4.869±0.233 2.937±0.122 Kep值 2.226±0.602 3.994±0.922 1.882±0.519 0.315±0.083 对照组 3 Ktrans值 0.518±0.054 0.595±0.050 0.595±0.033 0.633±0.029 Kep值 0.272±0.114 0.245±0.038 0.296±0.013 0.327±0.187 t1值 -15.77 -14.91 -40.35 -40.25 P1值 <0.001 <0.001 <0.001 <0.001 t2值 -5.39 -6.82 -6.83 0.13 P2值 0.002 <0.001 0.002 0.903 注：电烧伤组兔右下肢致高压电烧伤,对照组兔右下肢致假伤；DCE-MRI为动态对比增强磁共振成像；Ktrans值、Kep值处理因素主效应,F值分别为949.69、98.30,P值均<0.001；时间因素主效应,F值分别为47.95、16.15,P值均<0.001；两者交互作用,F值分别为49.55、17.69,P值均<0.001；t1值、P1值及t2值、P2值分别为2组间各时间点Ktrans值、Kep值比较所得 
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