兔膈神经移位术后早期轴浆流转运的核素显像研究

目的 探讨在体核素显像检测膈神经移位术后早期再生轴浆流转运的可行性，为临床应用提供依据。方法 选用^131I-酪氨酸和^99Tc^m-亚甲基二膦酸盐(MDP)，通过计算机图像融合，在兔动物模型中分别对正常坐骨神经及移位后膈神经进行轴浆流核素显像。结果 正常兔坐骨神经内轴浆流转运速率为30mm／d。膈神经移位术后1个月即可在再生良好组中测出^131I-酪氨酸通过吻合口向远端转运，转运速率为40mm／d。在瘢痕组中发现^131-酪氨酸不能向远端转运。^131I-酪氨酸在神经内的转运可用于在体示踪显像，与^99Tc-MDP图像融合可对转运图像进行定位。结论 该方法可在术后早期直观检测轴浆流通过神经吻合口的能力。

Detecting the transport of materials with axoplasm along the axon at the early stage after phrenic nerve neurotization via SPECT on a rabbit model

Objective To study the feasibility of estimating the regenerative quality of transferred phrenic ne rve by SPECT. Methods Two tracers, 131 I-tyrosine and 99 Tc m-methylene d iphosphonic acid (MDP) were selected. SPECT compounded with high-energy colli ma tion implement (for 131 I) and low-energy collimation implement ( for 99 Tc m) was used. A rabbit model was set up. 131 I-tyrosine was injected into the normal sciatic nerve and transferred phr enic nerve by micro-syringe. The SPECT scanning was carried out at different i ntervals. The tracing image of 131 I was used for detecting the ma terial migration along the axon and bone image of 99 Tc m-MD P was used for the bone orientation, these two images were interinfiltrat ed then. Results The radioactivity of 131 I-tyrosine could be detected by SPECT, the transportation speed was about 30 mm/d in rabbit 's normal sciatic nerve. For phrenic nerve transfer group, the 131 I-tyrosine was transported distally to the anastomotic site along with axoplasm in good regeneration group one month after anastomosis, the transportation spee d was 40 mm/d. In scar group, the 131 I-tyrosine was accumulated a pproximately at the anastomotic site and could not be transported distally. Conclusions The image of 131 I-tyrosine transported with n erve axoplasm could be displayed by SPECT in vivo. The method could be used to d etect the circulation of regenerated axoplasm passing through the anastomotic si te at the early stage after nerve transferring operation.