The Effects of Localized X-ray Irradiation on the Peripheral Nerve

Lee, Jong Gi; Lee, Chong Ryong; Suh, In Soo

Abstract

The authors studied the early morphologic changes of peripheral nerve, which is known as relatively radioresistant tissue to the X-ray irradiation, but recently clamied by several clinician through development of neuropathies after radiotherapy of the malignacy. Rabbits were received 1,000 or 2,000 cGy of X-ray on the knee joint areas. Sciatic nerves were extracted out 30 minutes, 1, 2, 4, 24 hours, and 3 and 7 days after irradiation. The morphologic changes were observed by light and electron microscopes. The results were summarized as follows: Light microscopically, only mild edema is noted. Electron microscopically, irregular separation and folding of myelin sheath with spherical body formation are noted. Above features were more prominent at later stages and aggregated nests of fragmented myelin were scattered 16 hours after irradiation. Schwann cell necrosis is noted after 24 hours. But above degenerative changes were scarcely present 7 days after irradiation. There is no remarkable axonal changes. The interstitial tissue revealed swelling and irregularity of surface of endothelial cells, and edema. On the basis of the results, it may be concluded that the peripheral nerve is injured by irradiation in early stages, and the main target of irradiation injury is thought to be myelin sheath and Schwann cells, which would be reversible and could be recovered promptly.