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| Content Provider | Springer Nature Link |
|---|---|
| Author | Hoffmann, Angelika Bredno, Jörg Wendland, Michael F. Derugin, Nikita Hom, Jason Schuster, Tibor Zimmer, Claus Su, Hua Ohara, Peter T. Young, William L. Wintermark, Max |
| Copyright Year | 2012 |
| Abstract | 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 = 0.034) and 24 h post reperfusion (p = 0.031). The predictive value of BBBP in terms of macroscopic hemorrhage was highest 4 h after reperfusion (ROC area under the curve = 84 %) 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. |
| Starting Page | 508 |
| Ending Page | 516 |
| Page Count | 9 |
| File Format | |
| ISSN | 18684483 |
| Journal | Translational Stroke Research |
| Volume Number | 3 |
| Issue Number | 4 |
| e-ISSN | 1868601X |
| Language | English |
| Publisher | Springer-Verlag |
| Publisher Date | 2012-09-16 |
| Publisher Place | New York |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Ischemic stroke MRI Blood–brain barrier Hemorrhagic transformation Neurosciences Vascular Surgery Cardiology Neurology Neurosurgery |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine Neuroscience Neurology (clinical) |
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