伽玛刀照射后正常大鼠脑形态学变化的观察.pdfVIP

伽玛刀照射后正常大鼠脑形态学变化的观察 海军总医院神经外科（北京 100037〕于 新 钟强 刘宗惠 周东学 亓树彬 胡 勇 李 冰 张 炜 【摘要】 目的 研究伽玛刀照射后正常大鼠脑形态学变化与时间和剂量的关系，同时 探讨晚期放射性坏死的放射机制。材料和方法 根据大鼠脑立体定位图谱，选择正常大鼠 右侧尾状核头部为照射靶点，按伽玛刀最大照射剂量分为 20 、50、75 、160Gy 四组，准 直器直径 4mm 。采用 HE 、Nissl 、Luxol Fast Blue 染色和抗片蛋白 (Laminin)抗体、胶质 细胞原纤维酸性蛋白(GFAP)抗体免疫组化染色。观察从伽玛刀照射开始到晚期坏死发生 过程中的形态学变化。结果 在晚期坏死灶出现之前的潜伏期内，靶区内病变主要包括两 个方面：①微血管系统改变，即毛细血管增生、微血管腔扩张、管壁增厚、血管周围组 织间隙水肿。②星形胶质细胞肥大、增生。结论 在晚期放射性坏死发生之前的潜伏期内， 大鼠靶区主要呈现微血管系统病变和星形胶质细胞肥大、增生。潜伏期内病变以及放射 性坏死的发生具有时间和剂量依赖性。 【关键词】伽玛刀 照射 形态学 大鼠 Histological changes in the normal rat brain after gamma irradiation 【Abstract 】 Objective To study time- and dose-related changes after gamma knife radiosurgery (GKR) in rat brains. Methods and Materials The right caudate nucleuses of Wistar rats were irradiated by OUR-XGD gamma units, stereotactic coordinates were obtained from the stereotactic atlas. Maximum dosages of 20,50,75 and 160Gy were given using a 4-mm collimator. HE, Nissl, Luxol Fast Blue staining and anti-GFAP, anti-Laminin staining were utilized to observe histological changes. Results Histological changes in the right caudate nucleuses such as microvessels injury which appeared as telangiectasia,vassodilation,vessel wall thickening and edema, astrocyte changes which appeared as hypertrophy and proliferation, were observed at various time points after GKR. Irradiation at a dosage of 20Gy elicited microvessels injury at 12 months and astrocyte changes at 15 months after GKR.No necrosis was observed until 15 months. Irradiation at a dosage of 50Gy resulted in microvessels injury and astrocyte changes at 6 months. Myelin loss, neuron loss and necrosis were observed at 12 months. Irradiation at a dosage of 75Gy elicited microvessels injury and astrocyte changes at 2 months, which became obvious at 4 months. Myelin loss and neuron loss were obs