MRI Blood–Brain Barrier Permeability Measurements to Predict Hemorrhagic Transformation in a Rat Model of Ischemic Stroke
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- 作者：Angelika Hoffmann (1) (6)
J?rg Bredno (3)
Michael F. Wendland (2)
Nikita Derugin (4)
Jason Hom (2)
Tibor Schuster (5)
Claus Zimmer (6)
Hua Su (7)
Peter T. Ohara (8)
William L. Young (7)
Max Wintermark (1) (2) - 关键词：Ischemic stroke ; MRI ; Blood–brain barrier ; Hemorrhagic transformation
- 刊名：Translational Stroke Research
- 出版年：2012
- 出版时间：December 2012
- 年：2012
- 卷：3
- 期：4
- 页码：508-516
- 全文大小：382KB
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J?rg Bredno (3)
Michael F. Wendland (2)
Nikita Derugin (4)
Jason Hom (2)
Tibor Schuster (5)
Claus Zimmer (6)
Hua Su (7)
Peter T. Ohara (8)
William L. Young (7)
Max Wintermark (1) (2)
1. Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908, USA
6. Department of Neuroradiology, Technische Universit?t München, Munich, Germany
3. CT and Nuclear Medicine, Imaging Physics and System Analysis, Philips Healthcare, San Jose, CA, USA
2. Department of Radiology, Neuroradiology Section, University of California San Francisco, San Francisco, CA, USA
4. Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
5. Institute of Medical Statistics and Epidemiology, Technische Universit?t München, Munich, Germany
7. Department of Anesthesia and Perioperative Care, Neurosurgery and Neurology, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, CA, USA
8. Department of Anatomy, University of California San Francisco, San Francisco, CA, USA - ISSN：1868-601X
文摘
Permeability imaging might add valuable information in the risk assessment of hemorrhagic transformation. This study evaluates the predictive value of blood–brain barrier permeability (BBBP) measurements extracted from dynamic contrast-enhanced MRI for hemorrhagic transformation in ischemic stroke. Spontaneously hypertensive and Wistar rats with 2?h filament occlusion of the right MCA underwent MRI during occlusion, at 4 and 24?h post reperfusion. BBBP was imaged by DCE imaging and quantified by Patlak analysis. Cresyl-violet staining was used to characterize hemorrhage in sacrificed rats at 24?h, immediately following the last imaging study. BBBP changes were evaluated at baseline, 4 and 24?h after reperfusion. Receiver-operating characteristic (ROC) analysis was performed to determine the most accurate BBBP threshold to predict hemorrhagic transformation. In animals showing macroscopic hemorrhage at 24?h, 95th BBBP percentile values ipsilateral were 0.323 [0.260, 0.387], 0.685 [0.385, 0.985], and 0.412 [0.210, 0.613]?ml/min·100?g (marginal mean [95%CI]) during occlusion, at 4 and 24?h post reperfusion, respectively. The BBBP values on the infarcted and contralateral side were significantly different at 4 (p--.034) and 24?h post reperfusion (p--.031). The predictive value of BBBP in terms of macroscopic hemorrhage was highest 4?h after reperfusion (ROC area under the curve--4?%) with a high negative predictive value (98.3?%) and limited positive predictive value (14.9?%) for a threshold of 0.35?ml/min·100g. Altered BBBP is a necessary but not sufficient condition to cause hemorrhagic transformation in rats with an infarct. Further research is needed to identify those additional risk factors that are required for hemorrhagic transformation to develop in the setting of ischemic stroke.