Magnetic Resonance Imaging Profile of Blood–Brain Barrier Injury in Patients With Acute Intracerebral Hemorrhage
| Autor: | Michael Mlynash, Christine A. C. Wijman, Roland Bammer, Nancy J. Fischbein, Irina Eyngorn, Sandeep N. Gupta, Ryan W Snider, Chitra Venkatasubramanian, Rashmi Narayana, Didem Aksoy |
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| Rok vydání: | 2013 |
| Předmět: |
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dynamic contrast‐enhanced MRI Pathology medicine.medical_specialty blood–brain barrier Blood–brain barrier 030218 nuclear medicine & medical imaging Pathogenesis 03 medical and health sciences 0302 clinical medicine Hematoma Edema Humans Medicine cardiovascular diseases Prospective Studies Stroke Original Research Cerebral Hemorrhage Intracerebral hemorrhage medicine.diagnostic_test business.industry Magnetic resonance imaging Middle Aged medicine.disease intracerebral hemorrhage Magnetic Resonance Imaging surgical procedures operative medicine.anatomical_structure Blood-Brain Barrier Acute Disease Dynamic contrast-enhanced MRI cardiovascular system Female medicine.symptom Cardiology and Cardiovascular Medicine business Nuclear medicine 030217 neurology & neurosurgery |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| DOI: | 10.1161/jaha.113.000161 |
| Popis: | Background Spontaneous intracerebral hemorrhage ( ICH ) is associated with blood–brain barrier ( BBB ) injury, which is a poorly understood factor in ICH pathogenesis, potentially contributing to edema formation and perihematomal tissue injury. We aimed to assess and quantify BBB permeability following human spontaneous ICH using dynamic contrast‐enhanced magnetic resonance imaging ( DCE MRI ). We also investigated whether hematoma size or location affected the amount of BBB leakage. Methods and Results Twenty‐five prospectively enrolled patients from the Diagnostic Accuracy of MRI in Spontaneous intracerebral Hemorrhage ( DASH ) study were examined using DCE MRI at 1 week after symptom onset. Contrast agent dynamics in the brain tissue and general tracer kinetic modeling were used to estimate the forward leakage rate (K trans ) in regions of interest ( ROI ) in and surrounding the hematoma and in contralateral mirror–image locations (control ROI ). In all patients BBB permeability was significantly increased in the brain tissue immediately adjacent to the hematoma, that is, the hematoma rim, compared to the contralateral mirror ROI ( P 30 mL) had higher K trans values than small hematomas ( P trans values of lobar hemorrhages were significantly higher than the K trans values of deep hemorrhages ( P trans values were associated with larger edema volumes. Conclusions BBB leakage in the brain tissue immediately bordering the hematoma can be measured and quantified by DCE MRI in human ICH . BBB leakage at 1 week is greater in larger hematomas as well as in hematomas in lobar locations and is associated with larger edema volumes. |
| Databáze: | OpenAIRE |
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