scholarly journals Permeability imaging as a predictor of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

2018 ◽  
Vol 38 (6) ◽  
pp. 973-979 ◽  
Author(s):  
Jonathan J Russin ◽  
Axel Montagne ◽  
Francesco D’Amore ◽  
Shuhan He ◽  
Mark S Shiroishi ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Magnetic Resonance ◽  
Blood Brain Barrier ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Brain Barrier ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Bbb Permeability

Blood–brain barrier (BBB) dysfunction has been implicated in ischemic risk following aneurysmal subarachnoid hemorrhage (aSAH), but never directly imaged. We prospectively examined whether post-bleed day 4 dynamic contrast-enhanced magnetic resonance (DCE-MR) BBB permeability imaging could predict development of delayed cerebral ischemia (DCI). Global MR-derived BBB permeability ( Ktrans) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10−3 min−1) compared to those who experienced radiographic vasospasm only (three patients; 1.85 ± 0.12 × 10−3 min−1; p < 0.05), or no vasospasm/ischemia (eight patients; 1.74 ± 0.07 × 10−3 min−1; p < 0.01). Ktrans > 2 × 10−3 min−1 predicted development of DCI (AUC = 0.98, 95% CI: 0.93–1). Global BBB dysfunction following aSAH is detectable with DCE-MR and predictive of ischemic risk.

scholarly journals The Use of Dynamic Contrast-Enhanced Magnetic Resonance Imaging for the Evaluation of Blood-Brain Barrier Disruption in Traumatic Brain Injury: What Is the Evidence?

2021 ◽  
Vol 11 (6) ◽  
pp. 775
Author(s):  
Sung-Suk Oh ◽  
Eun-Hee Lee ◽  
Jong-Hoon Kim ◽  
Young-Beom Seo ◽  
Yoo-Jin Choo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Magnetic Resonance ◽  
Blood Brain Barrier ◽  
Brain Barrier ◽  
Resonance Imaging ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced

(1) Background: Blood brain barrier (BBB) disruption following traumatic brain injury (TBI) results in a secondary injury by facilitating the entry of neurotoxins to the brain parenchyma without filtration. In the current paper, we aimed to review previous dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) studies to evaluate the occurrence of BBB disruption after TBI. (2) Methods: In electronic databases (PubMed, Scopus, Embase, and the Cochrane Library), we searched for the following keywords: dynamic contrast-enhanced OR DCE AND brain injury. We included studies in which BBB disruption was evaluated in patients with TBI using DCE-MRI. (3) Results: Four articles were included in this review. To assess BBB disruption, linear fit, Tofts, extended Tofts, or Patlak models were used. KTrans and ve were increased, and the values of vp were decreased in the cerebral cortex and predilection sites for diffusion axonal injury. These findings are indicative of BBB disruption following TBI. (4) Conclusions: Our analysis supports the possibility of utilizing DCE-MRI for the detection of BBB disruption following TBI.

Blood‐brain barrier dysfunction in canine epileptic seizures detected by dynamic contrast‐enhanced magnetic resonance imaging

Epilepsia ◽  
2019 ◽  
Vol 60 (5) ◽  
pp. 1005-1016 ◽  
Author(s):  
Erez Hanael ◽  
Ronel Veksler ◽  
Alon Friedman ◽  
Guy Bar‐Klein ◽  
Vladimir V. Senatorov ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Blood Brain Barrier ◽  
Epileptic Seizures ◽  
Brain Barrier ◽  
Resonance Imaging ◽  
Barrier Dysfunction ◽  
Dynamic Contrast Enhanced ◽  
Blood Brain ◽  
Contrast Enhanced

scholarly journals Magnetic resonance imaging of blood–brain barrier permeability in ischemic stroke using diffusion-weighted arterial spin labeling in rats

2016 ◽  
Vol 37 (8) ◽  
pp. 2706-2715 ◽  
Author(s):  
Yash V Tiwari ◽  
Jianfei Lu ◽  
Qiang Shen ◽  
Bianca Cerqueira ◽  
Timothy Q Duong
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Blood Brain Barrier ◽  
Brain Barrier ◽  
Resonance Imaging ◽  
Blood Brain Barrier Permeability ◽  
Dynamic Contrast Enhanced ◽  
Blood Brain ◽  
Contrast Enhanced ◽  
Brain Barrier Permeability

Diffusion-weighted arterial spin labeling magnetic resonance imaging has recently been proposed to quantify the rate of water exchange (Kw) across the blood–brain barrier in humans. This study aimed to evaluate the blood–brain barrier disruption in transient (60 min) ischemic stroke using Kw magnetic resonance imaging with cross-validation by dynamic contrast-enhanced magnetic resonance imaging and Evans blue histology in the same rats. The major findings were: (i) at 90 min after stroke (30 min after reperfusion), group Kw magnetic resonance imaging data showed no significant blood–brain barrier permeability changes, although a few animals showed slightly abnormal Kw. Dynamic contrast-enhanced magnetic resonance imaging confirmed this finding in the same animals. (ii) At two days after stroke, Kw magnetic resonance imaging revealed significant blood–brain barrier disruption. Regions with abnormal Kw showed substantial overlap with regions of hyperintense T2 (vasogenic edema) and hyperperfusion. Dynamic contrast-enhanced magnetic resonance imaging and Evans blue histology confirmed these findings in the same animals. The Kw values in the normal contralesional hemisphere and the ipsilesional ischemic core two days after stroke were: 363 ± 17 and 261 ± 18 min−1, respectively (P < 0.05, n = 9). Kw magnetic resonance imaging is sensitive to blood–brain barrier permeability changes in stroke, consistent with dynamic contrast-enhanced magnetic resonance imaging and Evans blue extravasation. Kw magnetic resonance imaging offers advantages over existing techniques because contrast agent is not needed and repeated measurements can be made for longitudinal monitoring or averaging.

Blood Brain Barrier Permeability in Patients With Reversible Cerebral Vasoconstriction Syndrome Assessed With Dynamic Contrast-Enhanced MRI

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012776
Author(s):  
Chia-Hung Wu ◽  
Jiing-Feng Lirng ◽  
Hsiu-Mei Wu ◽  
Yu-Hsiang Ling ◽  
Yen-Feng Wang ◽  
...  
Keyword(s):  
Blood Brain Barrier ◽  
Resistance Index ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Brain Barrier ◽  
Dynamic Changes ◽  
Whole Brain ◽  
Dynamic Contrast Enhanced ◽  
Cerebral Vasoconstriction ◽  
Contrast Enhanced ◽  
Bbb Permeability

Background and Objectives:Blood-brain barrier (BBB) disruption has been proposed important in the pathogenesis of reversible cerebral vasoconstriction syndrome (RCVS), yet not all patients present an identifiable macroscopic BBB disruption, i.e., visible contrast leakage on contrast-enhanced T2-fluid attenuated inversion recovery (CE-T2-FLAIR) imaging. This study aimed to evaluate microscopic BBB permeability and its dynamic change in patients with RCVS.Methods:This prospective cohort implemented 3-Tesla (3T) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). We measured microscopic BBB permeability by determining the whole-brain and white matter hyperintensity (WMH) Ktrans values and evaluated the correlation of whole-brain Ktrans permeability with clinical and vascular parameters in transcranial color-coded sonography (TCCS).Results:In total, 176 patients (363 scans) were analyzed and separated into acute (≦ 30 days) and remission (≧ 90 days) groups based on the onset-to-exam time. Whole-brain Ktrans values were similar between patients with and without macroscopic BBB disruption in either acute or remission stage. The whole-brain Ktrans was significantly decreased (p < 0.001) from acute to remission stages. The WMH Ktrans was significantly higher than mirror references and decreased from acute to remission stages (p < 0.001). Whole-brain Ktrans correlated with mean pulsatility index (rs = 0.5, p = 0.029), mean resistance index (rs = 0.662, p = 0.002) and distal-to-proximal ratio of resistance index (rs = 0.801, p < 0.001) of M1 segment of middle cerebral arteries at around 10-15 days after onset. The time-trend curve of whole-brain Ktrans depicted dynamic changes during disease course, similar to temporal trends of vasoconstrictions and WMHs.Discussion:Patients with RCVS presented increased microscopic brain permeability during acute stage, even without discernible macroscopic BBB disruption. The dynamic changes in BBB permeability may be related to impaired cerebral microvascular compliance and WMHs formation.

scholarly journals The Updated Role of the Blood Brain Barrier in Subarachnoid Hemorrhage: From Basic and Clinical Studies

2020 ◽  
Vol 18 (12) ◽  
pp. 1266-1278
Author(s):  
Sheng Chen ◽  
PengLei Xu ◽  
YuanJian Fang ◽  
Cameron Lenahan
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Brain Injury ◽  
Cerebral Ischemia ◽  
Clinical Outcome ◽  
Blood Brain Barrier ◽  
Ct Perfusion ◽  
Delayed Cerebral Ischemia ◽  
Early Brain Injury ◽  
Brain Barrier ◽  
Blood Brain

Subarachnoid hemorrhage (SAH) is a type of hemorrhagic stroke associated with high mortality and morbidity. The blood-brain-barrier (BBB) is a structure consisting primarily of cerebral microvascular endothelial cells, end feet of astrocytes, extracellular matrix, and pericytes. Post-SAH pathophysiology included early brain injury and delayed cerebral ischemia. BBB disruption was a critical mechanism of early brain injury and was associated with other pathophysiological events. These pathophysiological events may propel the development of secondary brain injury, known as delayed cerebral ischemia. Imaging advancements to measure BBB after SAH primarily focused on exploring innovative methods to predict clinical outcome, delayed cerebral ischemia, and delayed infarction related to delayed cerebral ischemia in acute periods. These predictions are based on detecting abnormal changes in BBB permeability. The parameters of BBB permeability are described by changes in computed tomography (CT) perfusion and magnetic resonance imaging (MRI). Kep seems to be a stable and sensitive indicator in CT perfusion, whereas Ktrans is a reliable parameter for dynamic contrast-enhanced MRI. Future prediction models that utilize both the volume of BBB disruption and stable parameters of BBB may be a promising direction to develop practical clinical tools. These tools could provide greater accuracy in predicting clinical outcome and risk of deterioration. Therapeutic interventional exploration targeting BBB disruption is also promising, considering the extended duration of post-SAH BBB disruption.

WED 168 Blood-brain barrier imaging with dynamic contrast-enhanced mri

2018 ◽  
Vol 89 (10) ◽  
pp. A21.2-A21
Author(s):  
Varatharaj Aravinthan ◽  
Liljeroth Maria ◽  
Darekar Angela ◽  
BW Larsson Henrik ◽  
Galea Ian ◽  
...  
Keyword(s):  
White Matter ◽  
Blood Brain Barrier ◽  
Cerebral Blood Volume ◽  
Brain Barrier ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Normal Appearing White Matter ◽  
Blood Brain ◽  
Contrast Enhanced ◽  
Bbb Permeability

BackgroundDynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can detect subtle blood-brain barrier (BBB) permeability. We developed a protocol and conducted experiments to validate the technique.Methods12 subjects with relapsing-remitting multiple sclerosis (RRMS) and 13 controls were recruited. Whole-brain 3D DCE-MRI at 3 Tesla was used to calculate the influx constant Ki (Patlak method). Values were derived for manual regions of interest (ROI) as well as segmented tissue masks. In controls, cerebral blood volume (CBV) was measured in grey and white matter.ResultsIn RRMS, Ki in visibly-enhancing lesions was significantly higher than in normal-appearing white matter (NAWM) (p=0.002). Ki in NAWM was significantly higher in RRMS than controls, by both ROI (p=0.014) and segmentation (p=0.019) methods. In controls, Ki was significantly higher in grey than white matter (p=0.001). CBV (and therefore vascular surface area) was also significantly higher in grey matter (p=0.005), with a mean ratio of 1.9.ConclusionsOur method produces results in line with the expected behaviour of a BBB permeability marker, and the grey/white matter CBV ratio is in agreement with the histologically-established value.

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