目的探讨DTI评价坐骨神经挤压伤的价值。方法建立32只兔坐骨神经挤压伤模型,并随机分为8组,每组4只,分别于损伤后24h、4天、8天、2周、4周、6周、8周、10周行DTI及纤维束示踪,并对4只兔在建模前扫描作为损伤前组;测量并比较损伤前及各时间段损伤远端坐骨神经FA值、λ⊥及λ∥,分析光镜及电镜下损伤远端神经的病理改变。结果 DTI纤维束重建显示挤压伤后远端神经截断,2周后远端纤维束逐渐增多,至10周时接近损伤前。损伤后24hFA值较损伤前下降(P〈0.01),损伤4天后FA值显著降低(P〈0.001);6周后FA值显著回升(P〈0.001),10周FA值仍低于损伤前(P〈0.01)。损伤后4天远端λ⊥显著升高(P〈0.001),6周后显著回落(P=0.007),10周后λ⊥恢复至损伤前水平。损伤后远端λ∥无显著变化。损伤远端FA值及λ⊥的变化与病理改变基本一致。结论 DTI能够反映兔坐骨神经挤压伤后神经变性及再生过程。
Objective: To explore the value of DTI in evaluating sciatic nerve crush injury of rabbit models. Methods: Sciatic nerve crush injury model of 32 New Zealand rabbits were established and randomly divided into 8 groups (each n=4). DTI scan and tractography were performed 24 h, 4 days, 8 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks and 10 weeks after injury accordingly, and 4 normal rabbits were scanned before building model (pre-injury group). FA, λ⊥ and λ// of sciatic nerve distal to the injury site were measured and compared. Meanwhile, the pathologic changes of the injured nerve were analyzed under light microscope and electron microscope. Results: DTI tractography showed that the distal part of injured nerve were invisible after injury, emerged 2 weeks after injury and increased in number and length gradually thereafter. The nerve fibers showed close to pre-injury level until 10 weeks after injury. FA of distal injured nerve dropped 24 h after injury (P〈0.01), dropped significantly 4 days after injury (P〈0.001), increased significantly 6 weeks after injury (P〈0.001), but remained lower than pre-injury group 10 weeks after injury (P〈0.01). λ⊥ of the distal injured nerve increased significantly 4 days after injury (P〈0.001). Six weeks after injury, λ⊥ dropped back significantly (P=0.007) and returned to pre-injury level 10 weeks after injury. There was no significant difference of λ// of the distal nerve after injury. FA and λ⊥ changes after injury were compatible with the pathologic changes. Conclusion: DTI is useful in reflecting degeneration and regeneration of rabbit sciatic nerve after crush injury.