The application of MRI for depiction of subtle blood brain barrier disruption in stroke
| Autor: | Yiftach Roth, Aharon Ocherashvilli, David Israeli, Chen Hoffman, Dianne Daniels, Yael Mardor, Mati Bakon, Amit Weinberg, Efrat Landau, David Guez, David Tanne, Ran Shneor, Talila Volk |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Subtle BBB disruption medicine.medical_specialty Time Factors media_common.quotation_subject brain Contrast Media Blood–brain barrier Applied Microbiology and Biotechnology 03 medical and health sciences 0302 clinical medicine Image Interpretation Computer-Assisted High spatial resolution Contrast (vision) Medicine Contrast extravasation Humans Molecular Biology Stroke Ecology Evolution Behavior and Systematics 030304 developmental biology media_common Aged Aged 80 and over 0303 health sciences medicine.diagnostic_test Short Research Communication business.industry Brain Neoplasms Magnetic resonance imaging Cell Biology Middle Aged medicine.disease Magnetic Resonance Imaging stroke Extravasation delayed enhancement medicine.anatomical_structure Blood-Brain Barrier Subtraction Technique Female Radiology Blood-brain barrier disruption business 030217 neurology & neurosurgery Developmental Biology Extravasation of Diagnostic and Therapeutic Materials MRI |
| Zdroj: | International Journal of Biological Sciences |
| ISSN: | 1449-2288 |
| Popis: | The development of imaging methodologies for detecting blood-brain-barrier (BBB) disruption may help predict stroke patient's propensity to develop hemorrhagic complications following reperfusion. We have developed a delayed contrast extravasation MRI-based methodology enabling real-time depiction of subtle BBB abnormalities in humans with high sensitivity to BBB disruption and high spatial resolution. The increased sensitivity to subtle BBB disruption is obtained by acquiring T1-weighted MRI at relatively long delays (~15 minutes) after contrast injection and subtracting from them images acquired immediately after contrast administration. In addition, the relatively long delays allow for acquisition of high resolution images resulting in high resolution BBB disruption maps. The sensitivity is further increased by image preprocessing with corrections for intensity variations and with whole body (rigid+elastic) registration. Since only two separate time points are required, the time between the two acquisitions can be used for acquiring routine clinical data, keeping the total imaging time to a minimum. A proof of concept study was performed in 34 patients with ischemic stroke and 2 patients with brain metastases undergoing high resolution T1-weighted MRI acquired at 3 time points after contrast injection. The MR images were pre-processed and subtracted to produce BBB disruption maps. BBB maps of patients with brain metastases and ischemic stroke presented different patterns of BBB opening. The significant advantage of the long extravasation time was demonstrated by a dynamic-contrast-enhancement study performed continuously for 18 min. The high sensitivity of our methodology enabled depiction of clear BBB disruption in 27% of the stroke patients who did not have abnormalities on conventional contrast-enhanced MRI. In 36% of the patients, who had abnormalities detectable by conventional MRI, the BBB disruption volumes were significantly larger in the maps than in conventional MRI. These results demonstrate the advantages of delayed contrast extravasation in increasing the sensitivity to subtle BBB disruption in ischemic stroke patients. The calculated disruption maps provide clear depiction of significant volumes of BBB disruption unattainable by conventional contrast-enhanced MRI. |
| Databáze: | OpenAIRE |
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