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实时磁共振成像引导下猪脑动脉溶栓治疗的实验研究

Thrombolytic therapy for cerebral arteries under real-time MR imaging guidance: an experiment in pigs
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摘要 目的探讨实时MR成像引导下治疗猪脑动脉栓塞的可行性。方法选用10只美国产的雌性小型猪作为实验对象。经皮穿刺股动脉,在实时MR成像的引导下,将3F主动追踪微导管分别插至双侧咽升动脉内。经3F微导管注入血栓堵塞咽升动脉,30～60min后,经3F微导管注射50万～75万u尿激酶溶栓。动脉增强MRA和冠状位压脂的MR冠状位T1成像评估溶栓治疗效果。结果 MRA证实,猪主要由双侧咽升动脉在颅底形成微血管网供应脑的血供。在实时MR成像引导下,10只猪的双侧咽升动脉经股动脉插管均获得成功,并完全被血栓堵塞。经动脉溶栓治疗后,血管内的血栓被溶解,堵塞的咽升动脉完全再通。结论在实时MR成像的引导下,进行猪的动脉溶栓治疗可行。 Objective To investigate the feasibility of thrombolytic therapy for cerebral arteries in experimental pigs under real-time MR imaging guidance. Methods Ten domestic female pigs （produced in U.S.A.） were enrolled in this study. After puncturing femoral artery with percutaneous technique, the bilateral ascending pharyngeal arteries were catheterized with 3 F active MR-tracking microcatheter under the guidance of real-time MR imaging. Then, aged thrombi were injected via the microcatheter to occlude the pharyngeal arteries. After 30-60 minutes, 500,000-750,000 units of urokinase were infused through the microcatheter into either one of the occluded ascending pharyngeal arteries for thrombolysis. Intraarterial contrast enhanced MRA and T1 fat suppressed coronal MR images were obtained to assess the vessel occlusion and the results of thrombolysis. Results MR angiography revealed that the major cerebral blood supply in pigs was obtained from the basicranial micro-vascular network which was formed by bilateral ascending pharyngeal arteries. Catheterization of ascending pharyngeal arteries via the femoral artery access was successfully performed in all 10 pigs under the guidance of real-time MR imaging. Both ascending pharyngeal arteries were totally occluded in all pigs after injection of aged thromboli. After urokinase infusion into the ascending pharyngeal arteries, the blood clots were resolved with re-established blood flow. Conclusion It is feasible to perform thrombolytic therapy for cerebral arteries under real-time MR imaging guidance.
作者 潘杰 Ervin Lin John Pile-Spellman 李玉梅 吴珣 谈非 金征宇
机构地区 中国医学科学院中国协和医科大学北京协和医院放射科 美国哥伦比亚大学医学中心
出处 《介入放射学杂志》 CSCD 北大核心 2010年第5期395-398,共4页 Journal of Interventional Radiology
关键词 实时MR成像引导 脑动脉 动脉溶栓 实验动物 猪 real-time MR imaging guidance cerebral artery arterial thrombolysis experimental animal pig
分类号 R743.3 [医药卫生—神经病学与精神病学]
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参考文献13

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二级参考文献31

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介入放射学杂志
2010年 第5期

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