Reliable estimation of microvascular flow patterns in patients with disrupted blood-brain barrier using dynamic susceptibility contrast MRI

2016 ◽  
Vol 46 (2) ◽  
pp. 537-549 ◽  
Author(s):  
Mikkel Bo Hansen ◽  
Anna Tietze ◽  
Jayashree Kalpathy-Cramer ◽  
Elizabeth R. Gerstner ◽  
Tracy T. Batchelor ◽  
...  
Keyword(s):  
Blood Brain Barrier ◽  
Flow Patterns ◽  
Brain Barrier ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Microvascular Flow ◽  
Reliable Estimation ◽  
Blood Brain ◽  
Dynamic Susceptibility Contrast Mri ◽  
Susceptibility Contrast

scholarly journals Predicting and optimizing the territory of blood–brain barrier opening by superselective intra-arterial cerebral infusion under dynamic susceptibility contrast MRI guidance

2015 ◽  
Vol 36 (3) ◽  
pp. 569-575 ◽  
Author(s):  
Miroslaw Janowski ◽  
Piotr Walczak ◽  
Monica S Pearl
Keyword(s):  
Blood Brain Barrier ◽  
Interventional Neuroradiology ◽  
Brain Regions ◽  
Brain Barrier ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Blood Brain ◽  
Dynamic Susceptibility Contrast Mri ◽  
Susceptibility Contrast ◽  
Tip Position

Interventional neuroradiology techniques are minimally invasive and allow for superselective drug delivery to specific brain regions. The passage of most agents, however, is impaired by the blood–brain barrier (BBB). Despite its discovery over 40 years ago, hyperosmotic BBB opening (BBBO) remains highly variable, preventing its widespread implementation. Here, we report on a technique that enables the prediction and optimization of the BBBO territory. We found that the microcatheter tip position and the speed of hyperosmolar mannitol injection, both major determinants of the targeted territory, can be modulated in real-time as guided by trans-catheter perfusion MRI.

scholarly journals Dynamic susceptibility contrast enhanced (DSC) MRI perfusion and plasma cytokine levels in patients after tonic-clonic seizures

2017 ◽  
Vol 51 (3) ◽  
pp. 277-285
Author(s):  
Tatjana Filipovic ◽  
Katarina Surlan Popovic ◽  
Alojz Ihan ◽  
David Bozidar Vodusek
Keyword(s):  
Plasma Level ◽  
Blood Brain Barrier ◽  
Brain Barrier ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Blood Brain ◽  
Dsc Mri ◽  
Contrast Enhanced ◽  
Clonic Seizures ◽  
Susceptibility Contrast

Abstract Background Inflammatory events in brain parenchyma and glial tissue are involved in epileptogenesis. Blood concentration of cytokines is shown to be elevated after tonic-clonic seizures. As a result of inflammation, blood-brain barrier leakage occurs. This can be documented by imaging techniques, such is dynamic susceptibility contrast enhanced (DSC) MRI perfusion. Our aim was to check for postictal brain inflammation by studying DSC MRI perfusion and plasma level of cytokines. We looked for correlations between number and type of introducing seizures, postictal plasma level of cytokines and parameters of DSC MRI perfusion. Furthermore, we looked for correlation of those parameters and course of the disease over one year follow up. Patients and methods We prospectively enrolled 30 patients, 8–24 hours after single or repeated tonic-clonic seizures. Results 25 of them had normal perfusion parameters, while 5 had hyperperfusion. Patients with hyperperfusion were tested again, 3 months later. Two of 5 had hyperperfusion also on control measurements. Number of index seizures negatively correlated with concentration of proinflammatory cytokines IL-10, IFN-ϒ and TNF-α in a whole cohort. In patients with hyperperfusion, there were significantly lower concentrations of antiinflammatory cytokine IL-4 and higher concentrations of proinflammatory TNF-a. Conclusions Long lasting blood- brain barrier disruption may be crucial for epileptogenesis in selected patients.

scholarly journals Spatiotemporal Characteristics of Postischemic Hyperperfusion with Respect to Changes in T1, T2, Diffusion, Angiography, and Blood–Brain Barrier Permeability

2011 ◽  
Vol 31 (10) ◽  
pp. 2076-2085 ◽  
Author(s):  
Qiang Shen ◽  
Fang Du ◽  
Shiliang Huang ◽  
Timothy Q Duong
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Blood Brain Barrier ◽  
Spatiotemporal Dynamics ◽  
Brain Barrier ◽  
Multiple Time ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Blood Brain ◽  
Susceptibility Contrast

The spatiotemporal dynamics of postischemic hyperperfusion (HP) remains incompletely understood. Diffusion, perfusion, T2, T1, angiographic, dynamic susceptibility-contrast magnetic resonance imaging (MRI) and magnetic resonance angiography were acquired longitudinally at multiple time points up to 7 days after stroke in rats subjected to 30-, 60-, and 90-minutes middle cerebral artery occlusion (MCaO). The spatiotemporal dynamics of postischemic HP was analyzed and compared with T1, T2 and blood-brain barrier (BBB) changes. No early HP within 3 hours after recanalization was observed. Late (≥12 hours) HP was present in all animals of the 30-minute MCAO group (N=20), half of the animals in the 60-minute MCAO group ( N=8), and absent in the 90-minute MCAO group (N=9). Dynamic susceptibility-contrast MRI and magnetic resonance angiography corroborated HP. Hyperperfusion preceded T2 increase in some animals, but HP and T2 changes temporally coincided in others. T2 peaked first at 24 hours whereas HP peaked at 48 hours after occlusion, and HP resolved by day 7 in most animals at which point the arteries became tortuous. Pixel-by-pixel tracking analysis showed that tissue did not infarct (migrated from core or mismatch at 30 minutes to normal at 48 hours) showed normal cerebral blood flow (CBF), whereas infarct tissue (migrated from core or mismatch at 30 minutes to infarct at 48 hours) showed exaggerated CBF, indicating that HP was associated with poor outcome.

scholarly journals Combined Perfusion and Permeability Imaging Reveals Different Pathophysiologic Tissue Responses After Successful Thrombectomy

2021 ◽  
Author(s):  
Arne Potreck ◽  
Matthias A. Mutke ◽  
Charlotte S. Weyland ◽  
Johannes A. R. Pfaff ◽  
Peter A. Ringleb ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Blood Brain Barrier ◽  
Hemorrhagic Transformation ◽  
Brain Barrier ◽  
Dynamic Susceptibility ◽  
Blood Brain Barrier Disruption ◽  
Flow Maps ◽  
Blood Brain ◽  
Patients At Risk ◽  
Brain Barrier Disruption

AbstractDespite successful recanalization of large-vessel occlusions in acute ischemic stroke, individual patients profit to a varying degree. Dynamic susceptibility-weighted perfusion and dynamic T1-weighted contrast-enhanced blood-brain barrier permeability imaging may help to determine secondary stroke injury and predict clinical outcome. We prospectively performed perfusion and permeability imaging in 38 patients within 24 h after successful mechanical thrombectomy of an occlusion of the middle cerebral artery M1 segment. Perfusion alterations were evaluated on cerebral blood flow maps, blood-brain barrier disruption (BBBD) visually and quantitatively on ktrans maps and hemorrhagic transformation on susceptibility-weighted images. Visual BBBD within the DWI lesion corresponded to a median ktrans elevation (IQR) of 0.77 (0.41–1.4) min−1 and was found in all 7 cases of hypoperfusion (100%), in 10 of 16 cases of hyperperfusion (63%), and in only three of 13 cases with unaffected perfusion (23%). BBBD was significantly associated with hemorrhagic transformation (p < 0.001). While BBBD alone was not a predictor of clinical outcome at 3 months (positive predictive value (PPV) = 0.8 [0.56–0.94]), hypoperfusion occurred more often in patients with unfavorable clinical outcome (PPV = 0.43 [0.10–0.82]) compared to hyperperfusion (PPV = 0.93 [0.68–1.0]) or unaffected perfusion (PPV = 1.0 [0.75–1.0]). We show that combined perfusion and permeability imaging reveals distinct infarct signatures after recanalization, indicating the severity of prior ischemic damage. It assists in predicting clinical outcome and may identify patients at risk of stroke progression.

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