Magnetic resonance imaging profile of blood-brain barrier injury in patients with acute intracerebral hemorrhage

Didem Aksoy, Roland Bammer, Michael Mlynash, Chitra Venkatasubramanian, Irina Eyngorn, Ryan W. Snider, Sandeep N. Gupta, Rashmi Narayana, Nancy Fischbein, Christine A C Wijman

Research output: Contribution to journalArticle

Abstract

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 (Ktrans) 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 (P30 mL) had higher Ktrans values than small hematomas (Ptrans values of lobar hemorrhages were significantly higher than the Ktrans values of deep hemorrhages (Ptrans 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.

Original languageEnglish (US)
Article numbere000161
JournalJournal of the American Heart Association
Volume2
Issue number3
DOIs
StatePublished - 2013
Externally publishedYes

Keywords

  • Blood-brain barrier
  • Dynamic contrast-enhanced MRI
  • Intracerebral hemorrhage
  • Magnetic resonance imaging
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Aksoy, D., Bammer, R., Mlynash, M., Venkatasubramanian, C., Eyngorn, I., Snider, R. W., Gupta, S. N., Narayana, R., Fischbein, N., & Wijman, C. A. C. (2013). Magnetic resonance imaging profile of blood-brain barrier injury in patients with acute intracerebral hemorrhage. Journal of the American Heart Association, 2(3), [e000161]. https://doi.org/10.1161/JAHA.113.000095