MR imaging and T2 measurements in peripheral nerve repair with activation of Toll-like receptor 4 of neurotmesis

Objective To investigate the role of MR imaging in neurotmesis combined with surgical repair and Toll-like receptor 4 (TLR4) activation. Methods Forty-eight rats received subepineurial microinjection of the TLR4 agonist lipopolysaccharide (LPS, n  = 24) or phosphate buffered saline (PBS, n  = 24) im...

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Bibliographic Details
Published in:European radiology 2014-05, Vol.24 (5), p.1145-1152
Main Authors: Zhang, Xiang, Zhang, Fang, Lu, Liejing, Li, Haojiang, Wen, Xuehua, Shen, Jun
Format: Article
Language:English
Subjects:
Animals
Diagnostic Radiology
Imaging
Internal Medicine
Interventional Radiology
Magnetic Resonance
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Nerve Regeneration
Neuroradiology
Neurosurgical Procedures
Peripheral Nerve Injuries - therapy
Radiology
Rats
Rats, Sprague-Dawley
Sciatic Nerve - metabolism
Sciatic Nerve - pathology
Sciatic Nerve - surgery
Surgery
Sutures
Toll-Like Receptor 4 - agonists
Toll-Like Receptor 4 - metabolism
Toll-Like Receptor 4 - physiology
Ultrasound
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Summary:Objective To investigate the role of MR imaging in neurotmesis combined with surgical repair and Toll-like receptor 4 (TLR4) activation. Methods Forty-eight rats received subepineurial microinjection of the TLR4 agonist lipopolysaccharide (LPS, n  = 24) or phosphate buffered saline (PBS, n  = 24) immediately after surgical repair of the transected sciatic nerve. Sequential fat-suppressed T2-weighted imaging and quantitative T2 measurements were obtained at 3, 7, 14 and 21 days after surgery, with histologic assessments performed at regular intervals. T2 relaxation times and histological quantification of the distal stumps were measured and compared. Results The distal stumps of transected nerves treated with LPS or PBS both showed persistent enlargement and hyperintense signal. T2 values of the distal stumps showed a rapid rise to peak level followed by a rapid decline pattern in nerves treated with LPS, while exhibiting a slow rise to peak value followed by a slow decline in nerves treated with PBS. Nerves treated with LPS exhibited more prominent macrophage recruitment, faster myelin debris clearance and more pronounced nerve regeneration. Conclusion Nerves treated with TLR4 activation had a characteristic pattern of T2 value change over time. Longitudinal T2 measurements can be used to detect the enhanced repair effect associated with TLR4 activation in the surgical repair of neurotmesis. Key points • TLR4 activation had additional beneficial effects on neurotmesis beyond surgical repair. • TLR4 activation had a characteristic time course of T2 values. • T2 measurements can help detect beneficial effects with TLR4 activation.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-014-3134-9