磁共振成像R2*map示踪超顺磁性氧化铁标记的内皮祖细胞

目的 探讨R2*map在超顺磁性氧化铁(SPIO)标记内皮祖细胞(EPCs)定量检测中的价值.方法 分离和培养Balb/c小鼠后肢骨髓来源的EPCs,培养7 d,用细胞膜红色荧光探针标记的乙酰低密度脂蛋白和异硫氰酸荧光素标记的荆豆凝集素-1双阳性染色法,以及异硫氰酸荧光素标记干细胞抗原1和藻红素标记的血管内皮细胞生长因子受体2的方法上流式细胞仪进行鉴定.用50 μg/ml SPIO及6 μl/ml lipofectamine 2000与EPCs共孵育进行标记后透射电子显微镜观察;制成不同细胞浓度(0～2.0×106/ml)标记及未标记SPIO的细胞琼脂糖模型,进行3.0T磁共振扫描,包括T2*map和T2map扫描,得到R2*map和R2map图像.结果 培养7d后细胞呈现内皮祖细胞特征.SPIO标记的EPCs细胞结构与未标记细胞相比较,无明显改变.R2*和R2值与标记SPIO的细胞浓度呈线性相关(r值分别为0.955,0.922,P值均<0.05);R2*效应明显高于R2效应(t=23.23,P<0.05).结论 磁共振成像R2*map扫描可准确定量示踪SPIO标记的EPCs.     

磁标记大鼠间充质干细胞肝脏移植的磁共振成像活体示踪

目的探讨1.5 T MRI活体示踪磁标记干细胞经门静脉肝脏移植的可行性。方法大鼠间充质干细胞以菲立磁和DAPI标记后,经门静脉注入大鼠肝脏,分别于移植前及移植后1 h、3 d、7 d和14 d行MRI扫描,并与组织荧光显像和铁染色对照。结果移植后1 h、3 d、7 d及14 d肝脏信噪比分别为1.10±0.26、8.18±1.55、11.08±1.30、14.15±1.02,7 d以内肝脏信噪比与移植前比较均有明显降低(P<0.05)。各时相肝组织铁染色与荧光显像的空间分布一致。结论1.5 T MRI活体示踪经门静脉移植的磁标记干细胞是可行的,MRI示踪时间可持续7 d。     

超顺磁性氧化铁活体动态示踪小型猪骨髓间充质干细胞的转归

目的探讨磁共振(MRI)下活体动态示踪小型猪骨髓间充质干细胞(MSCs)经冠脉移植治疗心肌梗死的可行性及移植后8周MSCs的转归。方法采用密度梯度离心法获取小型猪自体骨髓MSCs,用携带绿色荧光蛋白(GFP)基因的慢病毒载体转染MSCs,并用超顺磁性氧化铁(SPIO)体外标记MSCs-GFP。采用经皮球囊封堵法制备急性心肌梗死(AMI)模型,随机分为2组,MSCs移植组(n=8),经冠脉移植双标记的MSCs到小型猪心肌梗死区域,对照组(n=5),移植等量生理盐水,移植后24 h、3周、8周在MRI下进行活体动态示踪。8周后离体组织学观察大体形态学改变及移植细胞存留情况。结果普鲁士蓝染色显示25μg Fe/mL SPIO与0.8μl/mL阳离子脂质体联合对MSCs的标记率达95%～100%,标记后细胞活力和增值能力较前改变无统计学差异(P>0.05),对GFP的表达无影响,双标记细胞仍具备成骨、成脂及成心肌分化能力,心肌细胞表面标记物α-MHC和actinin表达阳性。双标记MSCs经冠脉移植后24 h,3周,8周MRI成像均可见梗死区域的室间隔有明显区别于周边组织的低信号,信号强度(SI)改变分别为52.98%±10.74%,21.53%±5.40%,6.23%±2.01%(P<0.05),对照组无可见低信号区域。组织学检查示MSCs移植组心梗瘢痕面积明显缩小(P<0.05),HE染色见心梗区域心内膜下出现再生心肌,普鲁士蓝染色可见有蓝色颗粒聚集,荧光显微镜下同一切片GFP表达阳性,CD68(单核巨噬细胞表面标记物)表达阴性。每高倍镜视野下心梗边缘区和梗死区的蓝色颗粒数分别为36.2±3.8和9.7±2.1(P<0.05)。对照组普鲁士蓝染色阴性。结论 GFP/SPIO双标记MSCs是安全的,且不改变干细胞的生物学特性。经冠脉移植双标记MSCs可在MRI成像下表现出理想的信号强度,示踪时间长达8周,MSCs移植可减小心梗瘢痕面积,促进心肌再生,8周后SPIO主要定居于心梗边缘区,仍存在于MSCs中,SPIO活体动态示踪小型猪骨髓MSCs?     

Resovist标记大鼠骨髓间充质干细胞移植治疗脑梗死的磁共振成像监测

目的探讨MRI监测Resovist体外标记大鼠骨髓间充质干细胞(BMSCs)移植治疗脑梗死后在脑内的分布及迁移。方法 16只大鼠随机分为对照组8只和移植组8只。BMSCs传至P3代后,Resovist体外标记BMSCs。采用改良Longa法制作大鼠脑梗死模型,移植组缺血对侧顸叶脑皮质移植Resovist标记的BMSCs,对照组不移植。2组大鼠均于移植后1 d和1、2、4周行MRI动态观察。移植后4周行脑组织HE染色及普鲁氏蓝染色。结果移植组大鼠移植后1 d和1、2、4周MRI序列上,均可显示缺血对侧半球移植的Resovist标记BMSCs所致的低信号,移植后2周可见沿胼胝体腹侧走行的线状低信号影,移植后4周细胞所致的彗星状改变更为明显,彗星尾向缺血侧延伸。脑组织普鲁氏蓝染色显示,移植组大鼠胼胝体内迁移的蓝染细胞呈条带状排列。结论临床应用型MRI可获得满意图像质量及实验数据,不仅可显示移植位点BMSCs所致的低信号,还可明确显示BMSCs经由胼胝体的迁移。     

细胞磁共振成像不能区分磁标细胞的存活状态

目的探讨不同状态下磁标记间充质干细胞(MSCs)的体内外磁共振(MR)成像特点,明确MR对细胞存活状态是否有鉴别诊断价值。方法分离培养猪骨髓MSCs,用超顺磁性铁纳米颗粒(SPIO)标记细胞24h。对未标记MSCs、存活的SPIO-MSCs、死亡的SPIO-MSCs、单纯SPIO进行体外凝胶内1.5TMR成像;开胸结扎前降支建立猪心肌梗死模型,于梗死交界区心肌内直接注射未标记MSCs、存活的SPIO-MSCs、死亡的SPIO-MSCs和单纯SPIO,然后进行体内T2*WI-flash序列MR成像。结果存活的SPIO-MSCs、死亡的SPIO-MSCs和单纯SPIO在体内外T2*WI-flash序列MR图像上均显示为低信号区,单凭图像无法区分。结论细胞MR成像无法区分组织磁标细胞、游离铁和含铁病变,因此对长期细胞示踪结果的解读应该慎重。     

VEGFR-2靶向超顺磁性氧化铁磁性纳米探针构建及肝癌细胞磁共振分子成像

目的制备血管内皮生长因子受体(VEGFR)-2靶向磁共振(MR)分子探针,探讨其对肝癌细胞的特异性靶向作用。方法采用共沉淀法制备超顺磁性氧化铁(SPIO),用壳聚糖对其表面进行修饰,耦联anti-VEGFR2抗体,制备VEGFR-2靶向MR分子探针(anti-VEGFR2-CS@SPION),以未修饰的SPIO纳米粒作为对照组。DLS法测量粒径大小、分布及Zeta电位,3.0T MR检测T2弛豫率。MTT法评价探针的安全性,通过激光共聚焦显微镜检测以及普鲁士蓝染色的方法验证探针与肝癌细胞结合的特异性。3.0T MR观察探针的体外MR成像能力。结果 SPIO和antiVEGFR2-CS@SPION的粒径分别为20.6 nm和38.4 nm;Zeta电位分别为-(20.3±1.32)m V、(3.58±1.28)m V。T2弛豫率分别为0.179×10~6M~(-1)S~(-1)、0.201×106M~(-1)S~(-1)。细胞毒性实验表明探针在高浓度下对细胞没有毒性;激光共聚焦显微镜检测显示,抗体探针与Hep G2细胞特异性结合;antiVEGFR2-CS@SPION与Hep G2细胞孵育后经普鲁士蓝染色,细胞内见较多的蓝染颗粒,而单纯SPIO组细胞内未见蓝色颗粒。体外MR成像显示,anti-VEGFR2-CS@SPION组、单纯SPIO组和空白对照组的T2值分别为(55.6±1.4)ms、(99.8±0.77)ms和(110.8±0.95)ms,差异有统计学意义(F=317.547,P<0.01)。结论壳聚糖修饰和SPIO标记的anti-VEGFR2抗体探针具有良好的生物学特性和体外肝癌细胞MR显像能力。     

葡萄糖受体介导的肿瘤靶向2-DG修饰超顺磁性氧化铁的制备及体外实验

目的 合成一种2-脱氧-D-葡萄糖(2-DG)包被γ-Fe2O3纳米探针,检测其性质特征及对前列腺癌PC3细胞葡萄糖受体的靶向性摄取.方法 运用化学共沉淀法合成γ-Fe2O3@二巯基丁二酸(DMSA),再与2-DG共轭生成γ-Fe2O3@DMSA-DG,红外光谱和透射电镜检测粒子结构特征;噻唑蓝试验(MTT)法进行细胞毒性实验,分别加入含无糖DMEM的探针培养基γ-Fe2O3@DMSA、γ-Fe2O3@DMSA-DG、γ-Fe2O3@DMSA-DG+ 2-DG(4.5 mg/mL),将探针在不同时间( 10 min、20 min、1h、2h)孵育PC3细胞,运用普鲁士兰染色法和铁三嗪法分析PC3细胞对探针的吸收情况,并以体外MRI观察T2WI信号强度变化.结果 2-DG以酰胺键连接γ-Fe2O3@DMSA,粒子平均直径10 mm;探针未见明显毒性;γ-Fe2O3@DMSA-DG可被PC3细胞靶向摄取,并可在早期被2-DG抑制.结论 本研究成功合成γ-Fe2O3@DMSA-DG探针,其对PC3细胞葡萄糖受体有较好的靶向性,使用临床型MR仪可对其进行监测.     

菲立磁标记猪骨髓间充质干细胞自体肝内移植的MR成像

目的:探索标记细胞肝内移植后磁共振威像技术.方法:获取猪自体骨髓间充质干细胞,分离、培养.应用菲立磁(Feridex)标记细胞,普鲁士蓝染色鉴定,标记细胞组n=6)和未标记细胞组(n=4)行经门静脉行肝内移植,分别于移植前,移植后6h、3 d、7d行磁共振T1WI,T2WI,T2*WI序列成像,同时行组织切片普鲁士蓝染色结果:普鲁士蓝染色表明MSCs的标记率达接近100%,磁标记MSCs肝内移植后行磁共振T2*WI序列呈明显低信号改变,并持续至细胞移植后7 d,组织切片普鲁士蓝染色显示7 d后肝内仍有移植的磁标记细胞存在于肝实质及肝血窦中.结论:利用Feridex可以在体外成功标记猪骨髓间充质干细胞,肝脏移植后行磁共振可以对标记细胞进行活体成像.     

超顺磁性氧化铁纳米粒子在癌症诊疗中的研究进展

<正>诊断治疗学是一种将诊断与治疗相结合的临床策略,可实现诊断与药物治疗同时进行,并可实时地获得疾病发生和发展信息,及时、合理地指导临床调整治疗方案,近年来作为一种新的治疗手段备受关注,特别在癌症诊疗领域有重大的应用前景。超顺磁性氧化铁纳米粒子(SPION)作为磁共振成像(MRI)的T2负性造影剂发挥重要作用,是分子影像学研究中的热点。SPION由磁铁矿或磁赤铁矿组成,直径在1～100 nm。主要特性包括:具有超顺磁性,     

小型猪骨髓间充质干细胞超顺磁氧化铁、增强型绿色荧光蛋白双标记及体外磁共振成像示踪的研究

目的 探讨超顺磁氧化铁(SPIO)和增强型绿色荧光蛋白(EGFP)体外双标记、磁共振成像(MRI)示踪1型糖尿病(T1DM)小型猪骨髓间充质干细胞(BMSCs)的可行性和标记方法.方法 采集T1DM小型猪骨髓,密度梯度离心和贴壁培养法分离BMSCs.选用携带EGFP慢病毒(LV)颗粒转染BMSCs.选用SPIO和左旋多聚赖氨酸(PLL)复合物标记LV-EGFP转染的BMSCs.对SPIO标记细胞进行普鲁士蓝染色、透射电镜观察和体外MRI.结果 LV-EGFP与BMSCs转染复数(MOI)为30∶1转染后96 h荧光表达最强,阳性转染率43.2%.Fe3+标记浓度为25 mg/L BMSCs阳性标记率93.1%.透射电镜检测发现,SPIO粒子密集于BMSCs细胞质,次级溶酶体内多见.MRI显示,Fe3+标记浓度为25 mg/L、1×104/ml细胞浓度标记后3周和6周在快速自旋回波序列(TSE)T1WI、TSET2WI及快速小角度激发成像(FLASH)T2*WI信号强度变化率(△SI)依次为12%、41%、63%和7%、28%、46%,均为后二者大于前者(分别P＜0.01和P＜0.05),提示SPIO该标记浓度和细胞密度标记后3周和6周在T2WI及T2*WI呈现较明显的信号变化.结论 采用体外EGFP和SPIO双重标记的方法,结合MRI和细胞化学染色法可以稳定地对T1DM小型猪BMSCs进行体外示踪.

Abstract：

Objectives To track bone marrow stem cells (BMSCs) labeled by enhanced green fluorescent protein (EGFP) and superparamagnetic iron oxide ( SPIO ) -poly-L-lysine (PLL) compound by MRI in vitro for autotransplantation into pancreas of type 1 diabetes miniature pigs. Methods The BMSCs were isolated by density gradient centrifugation and attachment culture from type 1 diabetes minipigs' bone marrow. Expressional intensity of EGFP in BMSCs transfected lentivirus-EGFP with a multiplicity of infection Different magnetic resonance scanning protocols were carried out on various density BMSCs labeled by different concentration of SPIO in various time-point in vitro. Results When SPIO concentration was 25mg/L (count in Fe3 + ), the positive Fe3+ -labeling rate of BMSCs was 93. 1%. Most of SPIO particles in BMSCs' cytoplasm were observed in secondary lysosomes, but they were not detected in important organelle as cell nucleus. Comparing with gelatin the MRI of BMSCs labeled with SPIO in the condition with 1 ×104/ml cells density and 25 mg/L Fe3+ concentration in vitro, the signal intensity changes (△SI) after BMSCs labeled with SPIO 3 weeks and 6 weeks in TSE T1WI, TSE T2WI and FLASH T2 * WI sequences were 12%, 41%, 63% and 7%, 28%, 46% respectively (P ＜ 0.01 and P ＜ 0.05, respectively).Conclusions The data showed that the porcine BMSCs labeled with SPIO and EGFP could be traced successfully in vitro by MRI in the suitable sequences.     

磁共振评价磁探针标记的骨髓单个核及骨髓间充质干细胞移植治疗猪急性心肌梗死的疗效

目的 骨髓单个核细胞(BM-MNC)及骨髓间质干细胞(MSC)经磁探针标记后,应用磁共振成像(MRI)观察磁探针标记的BM-MNC(MR-MNC)及MSC(MR-MSC)治疗猪急性心肌梗死(AMI)的疗效.方法 24头小型家猪经皮冠状动脉介入法成功制备AMI模型19头,随机分为MR-MSC组(n=7)、MR-MNC组(n=6)和AMI对照组(n=6),分别经冠状动脉途径植入MR-MSC、MR-MNC(细胞总数1×107)和含菲立磁标记物的磷酸盐缓冲液,MRI爪踪移植细胞并观察8周后不同细胞类型移植对梗死心肌面积及心功能的影响,最后行组织学检查鉴定移植细胞及其功能.结果 MRI示MR-MSC组、MR-MNC组均见呈低信号的标记细胞归巢至呈高信号的梗死心肌区周边或梗死心肌内.与移植前相比,8周后MRI测定梗死心肌而积在标记细胞移植组均明显缩小(MR-MSC组8.5%±0.5%比24.7%±3.1%,P＜0.05;MR-MNC组12.3%±1.5%比26.1%±1.5%,P＜0.05);左室射血分数(LVEF)均有明显提高(MR-MSC组56.9%±1.3%比40.7%±2.0%,P＜0.05;MR-MNC组52.8%±1.4%比41.9%±3.3%,P＜0.05),但MR-MSC组LVEF改善程度优于MR-MNC组(16.2%±1.2%比10.9%±3.0%,P＜0.05).普鲁士蓝染色证实标记细胞分布与MRI所见低信号区分布基本一致.Western blot分析显示心肌再生指标肌球蛋白重链表达在MR-MSC组(100.3±5.5)及MR-MNC组(95.5±4.2)均高于AMI对照组(75.7±5.7);心肌特异性肌钙蛋白T在MR-MSC组(124.0±5.8)及MR-MNC组(118.4±4.4)均高于AMI组(93.3±3.9);心肌重构指标基质金属蛋白酶2(MMP2)/MMP抑制剂1(TIMP1)在MR-MSC组(0.6±0.1)及MR-MNC组(0.6±0.1)低于AMI对照组(4.2±0.2).结论 MR-MSC及MR-MNC可在体分化成表达心肌特异性蛋白的心肌样细胞,延缓心室重构,缩小梗死心肌面积,改善整体心窒收缩功能,且MR-MSC对心功能改善程度优于MR-MNC.     

磁共振成像对猪不同心脏状态下经冠状动脉干细胞移植后体内再分布的评价

目的 探讨磁共振成像在停跳与不停跳两种心脏状态下,对猪心肌梗死模型经冠状动脉注射骨髓间充质干细胞后全身各主要脏器干细胞早期再分布中的应用价值.方法 用带球囊导管经股动脉选择性插管至雌猪左冠状动脉前降支,在第二对角支的近端将球囊扩张90 min建立急性心肌梗死模型.模型建立后7 d,随机分为4组,分别为不停跳心脏细胞移植组(不停跳组,n=6)与对照组(n=6),停跳心脏细胞移植组(停跳组,n=6)与对照组(n=6).超顺磁氧化铁颗粒(SPIO)标记的干细胞移植3 d后,行磁共振T2*WI示踪检查.取动物心、肝、脾、肺、肾脏的标本,用实时定量聚合酶链反应检测雄性细胞特异性的SRY基因,切片进行普鲁士蓝染色,观察细胞在体内的分布和形态.结果 除肾脏外,心、脾、肝中干细胞移植组T2*值较对照组差异均有统计学意义,但移植组在不同心脏状态下不停跳组与停跳组心肌T2*值差异无统计学意义[(-7.81±2.03)ms比(-6.56±1.72)ms,P＞0.05],而不停跳组脾脏及肝脏的T2*值明显低于停跳组[脾脏:(-16.72±2.83)ms比(-22.18±3.98)ms,P＜0.01,肝脏:(-2.40±0.44)ms比(-5.32±3.40)ms,P＜0.05],在肾脏中两组差异无统计学意义.SRY基因在不停跳组及停跳组的脾脏及肝脏的表达差异有统计学意义,病理学检查见移植细胞呈普鲁士蓝染色阳性.结论 干细胞SPIO标记后,磁共振成像可以作为方便而有效的手段在移植早期活体示踪干细胞,评价其在体内的分布情况.经冠状动脉途径注射骨髓间充质干细胞后,许多细胞流向心脏以外的器官,尤其是脾脏.心脏停跳与不停跳状态下经冠状动脉注射骨髓间充质干细胞对干细胞在心脏的滞留无明显差别.     

磁共振成像对冠心病陈旧性心肌梗死所致心功能不全的诊断及干细胞移植疗效评价的应用

目的 评价磁共振成像(MRI)在冠心病陈旧性心肌梗死合并心功能不全患者诊断中的价值,并分析干细胞移植手术的疗效.方法 20例冠心病陈旧性心肌梗死患者,男18例,女2例,年龄(59.5±10.1)岁,半均分成2组(每组10例),干细胞移植组行冠状动脉旁路移植术(CABG)+干细胞移植,对照组仅行CABG术,术前均行心脏MRI及双核素单光子发射计算机断层(SPECT)进行存活心肌显像检查,术后6个月复查心脏MRI.用MRI评价干细胞移植后左心功能改善及心脏MRI延迟增强显像判断左室存活心肌的准确性.结果 两组左室射血分数(LVEF)均有明显改善,但手术前后变化值比较差异无统计学意义.干细胞移植组左室舒张末期容积(LVEDV)手术前后变化值为(9.91±39.50)ml,与对照组的(-22.34±31.35)ml比较,差异有统计学意义(P＜0.05);干细胞移植组窒壁增厚率变化值高于对照组(11.40%±11.53%比2.27%±7.20%,P＜0.05),其余两组心功能参数变化值比较差异均无统计学意义.心脏MRI延迟增强显像与氟-18-脱氧葡萄糖(18F-FDG)心肌代谢存活心肌显像具有较好的一致性,Kappa=0.446(P＜0.001).以18F-FDG SPECT心肌代谢显像为金标准,心脏MRI延迟增强显像敏感度为68.3%,特异度为92.5%.结论 MRI能够准确判断冠心病陈旧性心肌梗死患者左室容积和功能,对心肌梗死后存活心肌的判断具有同18F-FDG SPECT相近的特异性,但敏感件略低.MRI可用于心肌十细胞移植前诊断与移植后早期疗效的判定.     

Functional assessment of myoblast transplantation for cardiac repair with magnetic resonance imaging

BACKGROUND: Contraction of transplanted myoblasts and their effects on function and remodeling after myocardial infarction remain controversial. AIM: We used magnetic resonance imaging (MRI) to study wall thickening and left ventricular (LV) function and geometry after myoblast transplantation. METHODS AND RESULTS: Three weeks after cryo-infarction rabbits were randomized to receive an injection of approximately 2 x 10(8) myoblasts (n=8) or medium (n=9) into the scar. Cine MRI and contrast enhanced (ce) MRI images were acquired before injection (baseline) and 4 weeks later (endpoint). Regional wall thickening was measured at the site of transmural hyperenhancement. In the control group, regional wall thickening decreased to -15.3+/-8.6% at baseline, which further decreased to -18.3+/-5.7% at endpoint. Further, end-diastolic volume increased from 3.96+/-0.27 to 5.00+/-0.46 ml and end-systolic volume from 2.23+/-0.19 to 2.96+/-0.30 ml (both P<0.05 vs. baseline), which was accompanied by increased LV wall volumes (P<0.05 vs. baseline). In contrast, myoblast transplantation increased regional wall thickening from -11.9+/-15.9% at baseline to 26.9+/-17.0% (P<0.05 vs. control), which resulted in significantly improved two-dimensional ejection fractions at the infarct level and prevented the increase in end-diastolic and end-systolic volumes and wall volume. CONCLUSION: Intracardiac myoblast transplantation after myocardial infarction improves regional wall thickening and prevents progressive left ventricular remodeling.     

Imaging of stem cells using MRI

The administration of exogenous stem cells offers promise to regenerate many damaged organs. However, failures of these cellular therapies could be related to many issues, such as the type of stem cell, the dose of cellular therapeutic, dosing regime, and mode of delivery. The recent ability to directly label stem cells with magnetic resonance (MR) contrast agents provides a simple, straight-forward manner to monitor accurate cell delivery and track stem cells non-invasively in a serial manner. Provided here is an overview of the currently available MR-labeling methods, including direct non-specific labeling with contrast agents, indirect specific labeling with contrast agents, labeling with MRI reporter genes, and fluorine hot spot labeling. Several of these approaches have now been applied successfully in preclinical animal models of cardiovascular disease. Once properly implemented, future clinical trials may benefit greatly from imaging stem cells with MRI.     

细胞因子微球加强骨髓间充质干细胞移植对猪心肌梗死的疗效

目的 通过观察血管内皮生长因子(VEGF)缓释明胶微球与自体骨髓间充质干细胞(MSC)联合移植于猪心肌梗死模型梗死周边区3周后MSC的生存情况,结合磁共振成像(MRI),阐明改善局部微环境对自体MSC移植于缺血心肌后转归的影响,并直观评价MRI对移植MSC在体示踪及半定量分析的可靠性.方法 以乳化冷凝法制备VEGF缓释明胶微球并评价其缓释性能.成年中华小型猪12头,抽取髂骨骨髓并制备自体MSC,以顺磁性氧化铁颗粒(SPIO)和4',6-二脒基-2-苯基吲哚(4',6-Diamidino-2-phenylindole dihydrochloride,DAPI)标记细胞.按照随机化表将动物分为MSC移植组及MSC-VEGF缓释微球联合移植组.开胸结扎冠状动脉左前降支制备小型猪心肌梗死模型后第14天,直视下经心外膜于MSC组动物心肌梗死周边区注射MSC(9×107),于MSC-VEGF缓释微球组注射MSC(9×107)及VEGF缓释明胶微球(含9 μg人重组VEGF165).细胞和(或)微球移植后24 h及21 d,磁共振FGRE序列T2*像检测干细胞移植点低信号区的面积及信号强度.病理组织学检测细胞移植区域心肌组织毛细血管密度及干细胞存活情况.结果 明胶微球平均粒径为(104.0±22.6)μm,体内、外缓释VEGF均可达到10 d以上.小型猪心肌梗死模型建立后第14天,梗死区面积为33.6%±8.9%.细胞移植后24 h,MSC注射点于MRI显示为边界清晰的卵圆形T2*低信号区,细胞移植3周后,两组注射点T2*低信号区面积均减小(P<0.05),其与正常心肌组织间的信号对比度均减低(P<0.05).MSC-VEGF缓释微球组移植点毛细血管密度高于MSC组[(15.2±5.4)个/高倍视野比(10.2±5.0)个/高倍视野,t=2.43,P<0.05].MSC-VEGF缓释微球组MSC注射点移植细胞数多于MSC组[(354±83)个/高倍视野比(278±97)个/高倍视野,t=3.14,P<0.05],而MSC凋亡率则小于MSC-VEGF缓释微球组[(6.4±4.1)%比(11.9±4.8)%,t=2.97,P<0.05].结论 VEGF缓释明胶微球可以改善移植于缺血心肌区3周后MSC的生存情况.移植干细胞所生存的微环境是影响其转归的重要因素.MRI对于移植干细胞位置的在体示踪是可靠的,但不能作为对移植细胞定量或半定量分析的依据.     

Fragmented QRS complexes are not hallmarks of myocardial injury as detected by cardiac magnetic resonance imaging in patients with acute myocardial infarction

Background

Q waves on a 12-lead electrocardiography (ECG) are considered to be classic hallmarks of prior myocardial infarction. However, one study suggested that the fragmented QRS complex (fQRS) on ECG is a highly sensitive and specific marker of myocardial scarring on a nuclear stress test. The study aimed to investigate the diagnostic accuracy of fragmented QRS complexes compared with Q waves for myocardial injury detected by delayed contrast-enhanced cardiovascular magnetic resonance imaging (DE-CMRI) in subjects with acute myocardial infarction.

Methods

Electrocardiograms of 190 subjects with myocardial infarction who underwent DE-CMR were analyzed. fQRS was defined by the presence of an additional R wave (R″), or notching of the S wave, or more than one R′ in two contiguous leads.

Results

Delayed enhancement was observed in 180 (94.7%) patients. Transmural enhancement was noted in 78 (43.3%) and subendocardial enhancement in 102 (56.7%) patients. The sensitivity and specificity of Q waved and fQRS for diagnosing delayed enhancement were 59.4% vs. 66.7% and 90.0% vs. 40.0%. The area under the receiver–operator characteristics curve of delayed enhancement was 0.75 for Q waves and 0.53 for fQRS (p = 0.04). The areas under the ROC curves of the transmurality of delayed enhancement were 0.44 for fQRS and 0.58 for Q waves (p = 0.73).

Conclusions

fQRS has poor accuracy for the detection of myocardial injury compared with Q waves. fQRS and Q waves are not valuable tools for the diagnosis transmural irreversible myocardial injury in acute myocardial infarction.     

Current status of superparamagnetic iron oxide contrast agents for liver magnetic resonance imaging

Five types of superparamagnetic iron oxide(SPIO), i.e. Ferumoxides(Feridex~ Ⅳ, Berlex Laboratories), Ferucarbotran(Resovist~, Bayer Healthcare), Ferumoxtran-10(AMI-227 or Code-7227, Combidex~, AMAG Pharma; Sinerem~, Guerbet), NC100150(Clariscan~, Nycomed,) and(VSOP C184, Ferropharm) have been designed and clinically tested as magnetic resonance contrast agents. However, until now Resovist~ is current available in only a few countries. The other four agents have been stopped for further development or withdrawn from the market. Another SPIO agent Ferumoxytol(Feraheme~) is approved for the treatment of iron deficiency in adult chronic kidney disease patients. Ferumoxytol is comprised of iron oxide particles surrounded by a carbohydrate coat, and it is being explored as a potential imaging approach for evaluating lymph nodes and certain liver tumors.     

Haematopoietic stem cells improve cardiac function after infarction without permanent cardiac engraftment

BACKGROUND: Transplantation of bone marrow derived adult stem cells (BMC) improves cardiac function after acute myocardial infarction (MI). However, the cell population mediating myocardial recovery and the fate of the transplanted cells are still controversial. AIMS: We determined the effects of Sca-1+ c-kit+ lin- haematopoietic BMC on cardiac function after MI and the cell fate after transplantation. METHODS: Sca-1+ c-kit+ lin- BMC of male donor C57BL/6 mice were transplanted by intravenous injection into syngenic females after permanent MI. LV dimensions and function were determined by echocardiography and cardiac magnetic resonance imaging, transplanted BMC were identified by Y chromosome DNA in situ hybridization. RESULTS: BMC treatment completely prevented LV dilation (LV end-diastolic volume BMC 70 +/- 16 microl vs. control 122 +/- 41 microl; p < 0.05) and improved fractional shortening (BMC 22.9 +/- 8% vs. control 15.4 +/- 8.4%; p < 0.05) and ejection fraction BMC 68.2 +/- 6.6% vs. control 52 +/- 14.3%; p < 0.05) as early as 3 days after transplantation, but did not decrease infarct size (BMC 27 +/- 6% vs. control 28 +/- 7%, p = n.s.). After 4 weeks, only sporadic cells of male origin were identified in infarcted hearts (< 0.01% of periinfarct cells). CONCLUSION: Intravenous injection of Sca-1+ c-kit+ lin- in BMC after MI improves LV dimensions and function without evidence for long term engraftment.