荧光素血管造影用于监测慢性神经压迫性神经病的神经血流:实验动物模型和初步临床观察。

IF 3.2 Q2 CLINICAL NEUROLOGY Neurology International Pub Date : 2024-09-05 DOI:10.3390/neurolint16050074
Kosuke Saito, Mitsuhiro Okada, Takuya Yokoi, Shunpei Hama, Hiroaki Nakamura
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引用次数: 0

摘要

据报道,慢性神经压迫(CNC)神经病患者会出现与神经血液紊乱相关的病变。荧光素血管造影术(FAG)和激光多普勒血流测量仪(LDF)是实时评估周围神经血流的有效方法。然而,它们在大型动物严重神经病变模型或临床条件下的可靠性仍不明确。最初,我们的目标是将 FAG 应用于两种不同的 CNC 动物模型,并评估它们与 LDF 相比的特点。在 FAG 中,我们量化了注射荧光素后压迫部位的峰值亮度。然后,我们将 LDF 探头置于压迫部位的中心并记录血流。随后,我们分析了动物实验中获得的 FAG 特性是否与严重腕管综合征(CTS)患者的临床研究结果一致。在 CNC 大鼠模型中,FAG 和 LDF 可有效监测神经血流随时间推移而减少的情况。在新开发的严重腕管综合征兔模型中,我们使用这两种技术观察到血流量明显减少。值得注意的是,与 LDF 不同,FAG 与电诊断结果中的复合肌肉动作电位(CMAP)振幅密切相关。下一步,我们在 CTS 临床病例的腕管开放松解术后进行了 FAG。FAG 与术前 CMAP 振幅有明显相关性。这表明 FAG 在手术过程中评估神经血流的重要性,有可能提高诊断准确性和手术效果。
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Fluorescein Angiography for Monitoring Neural Blood Flow in Chronic Nerve Compression Neuropathy: Experimental Animal Models and Preliminary Clinical Observations.

Pathologies associated with neural blood disturbance have been reported in patients with chronic nerve compression (CNC) neuropathy. Fluorescein angiography (FAG) and laser Doppler flowmetry (LDF) are effective for real-time peripheral nerve blood flow assessment. However, their reliability in severe neuropathy models in large animals or clinical conditions remains unclear. Initially, we aim to apply FAG to two different CNC animal models and evaluate their characteristics in comparison with those of LDF. In FAG, we quantified the peak luminance at the compression site following fluorescein injection. Then, we positioned the LDF probe at the center of the compression site and recorded the blood flow. Subsequently, we analyzed whether the FAG characteristics obtained in this animal experiment were consistent with those of clinical studies in patients with severe carpal tunnel syndrome (CTS). In the CNC rat model, FAG and LDF effectively monitored reduced neural blood flow over time. We observed significant blood flow reduction using both techniques in a newly developed severe CNC rabbit model. Notably, FAG correlated strongly with the compound muscle action potential (CMAP) amplitude in electrodiagnostic findings, unlike LDF. As a next step, we performed FAG after open carpal tunnel release in clinical cases of CTS. FAG correlated significantly with preoperative CMAP amplitude. This indicates FAG's importance for assessing nerve blood flow during surgery, potentially improving diagnostic accuracy and surgical outcomes.

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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
期刊最新文献
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