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目的:探讨大鼠新型隐球菌脑感染早期MRI表现及其病理基础。方法:将96只Wistar大鼠随机分成免疫抑制感染组(n=40)、正常状态感染组(n=40)、单纯免疫抑制对照组(n=8)、正常对照组(n=8)。感染组侧脑室内注射新型隐球菌菌液。第7、14、21、28天使用1.5TMR对大鼠颅脑进行常规平扫、增强、DWI等多序列检查,定期处死观察病变处病理变化情况。结果:①脑膜强化:第7天MRI扫描可见感染组大鼠脑膜轻度强化,免疫抑制感染组和正常状态感染组大鼠在第7、14、21、28天脑膜强化分别为4、4、3、3和2、1、1、1只;②脑实质病灶:第7、14、21、28天两组大鼠脑实质内病灶分别为1、3、6、6和0、0、1、1只,两组之间在第21、28天存在统计学差异(P=0.04)。③脑室扩大:第21天开始见脑室扩大,免疫抑制感染组与正常状态感染组分别为4只、1只,第28天脑室扩大更明显,两组分别为6只、1只;④动态观察:免疫抑制状态下动态观察组脑内病灶随时间延长而变大,病灶变多,脑室扩大更明显;⑤病理检查:脑膜或脑实质病变处可见隐球菌菌体,局部淋巴细胞聚集,脑实质内可见隐球菌菌落周围胶样团块,局灶性坏死。结论:免疫抑制状态下,大鼠更易发生新型隐球菌脑感染。大鼠新型隐球菌脑感染的MRI早期表现为脑膜脑炎,脑实质内感染在MRI上表现为局限性炎症,胶样假囊,随感染时间延长可见脑室系统的扩大。
Objective: To investigate the MRI features and pathogenesis of Cryptococcus neoformans infection in rats at early stage. Methods: Ninety - six Wistar rats were randomly divided into immunosuppressed group (n = 40), normal infection group (n = 40), immunosuppressed control group (n = 8) and normal control group (n = 8). Infected group intracerebroventricular injection of Cryptococcus neoformans bacteria solution. On the 7th, 14th, 21st, 28th day, 1.5TMR was used to routinely scan and enhance the brain of rats. DWI and other multiple sequence examination were performed. The pathological changes of lesions were observed regularly. Results: (1) Meningeal enhancement: On the 7th day of MRI scan, the meninges in the infected group were mildly enhanced. In the immunosuppressed group and the normal infection group, the meninges were enhanced on the 7th, 14th, 21st and 28th days respectively. 3,3 and 2,1,1,1 only; ② parenchymal lesions: on the 7th, 14th, 21st and 28th days, the intraparenchymal lesions in the two groups were 1, 3, 6, 6 and 0, 0, 1 , And there was a statistically significant difference between the two groups on the 21st and 28th days (P = 0.04). ③ ventricular enlargement: see the beginning of the 21st day to see the ventricular enlargement, immunosuppressed infection group and the normal state infection group were 4, 1, 28 days more ventricular enlargement more obvious, the two groups were 6, 1; ④ dynamic observation : Immunosuppressive state dynamic observation group brain lesions with the passage of time become larger, more lesions, ventricular enlargement more obvious; ⑤ pathological examination: lesions of meninges or brain parenchyma cryptococcal cells can be seen, local lymphocyte aggregation, brain parenchyma Cryptococcal colonies can be seen around the gum-like mass, focal necrosis. Conclusion: In immunosuppressed state, the rat is more susceptible to Cryptococcus neoformans infection. MRI of Cryptococcus neoformans infection in early manifestation of meningoencephalitis, intraparenchymal infection in MRI showed localized inflammation, plastic-like pseudocyst, with the extension of infection can be seen ventricular expansion.