https://scholars.lib.ntu.edu.tw/handle/123456789/380171
Title: | Effects of microvascular permeability changes on contrast-enhanced t1 and pharmacokinetic mr imagings after ischemia | Authors: | Liu, H.-S. Chung, H.-W. Chou, M.-C. Liou, M. Wang, C.-Y. Kao, H.-W. Chiang, S.-W. Juan, C.-J. Huang, G.-S. Chen, C.-Y. HSIAO-WEN CHUNG |
Keywords: | bloodbrain barrier; Ktrans; parenchymal enhancement | Issue Date: | 2013 | Journal Volume: | 44 | Journal Issue: | 7 | Start page/Pages: | 1872-1877 | Source: | Stroke | Abstract: | BACKGROUND AND PURPOSE - : Brain enhancement on contrast-enhanced T1-weighted imaging (CET1-WI) after ischemic stroke is generally accepted as an indicator of the blood-brain barrier disruption. However, this phenomenon usually starts to become visible at the subacute phase. The purpose of this study was to evaluate the time-course profiles of K, cerebral blood volume (vp), and CET1-WI with early detection of blood-brain barrier changes on K maps and their role for prediction of subsequent hemorrhagic transformation in acute middle cerebral arterial infarct. METHODS - : Twenty-six patients with acute middle cerebral arterial stroke and early spontaneous reperfusion, whose MR images were obtained at predetermined stroke stages, were included. T2*-based MR perfusion-weighted images were acquired using the first-pass pharmacokinetic model to derive K and vp. Parenchymal enhancement observed on maps of K, vp, and CET1-WI at each stage was compared. Association among these measurements and hemorrhagic transformation was analyzed. RESULTS - : K map showed significantly higher parenchymal enhancement in ischemic parenchyma as compared with that of vp map and CET1-WI at early stroke stages (P<0.05). The increased K at acute stage was not associated with parenchymal enhancement in CET1-WI at the same stage. Parenchymal enhancement in CET1-WI started to occur at the late subacute stage and tended to be luxury reperfusion-dependent. Patients with hemorrhagic transformation showed higher mean K values as compared with patients without hemorrhagic transformation (P=0.02). CONCLUSIONS - : Postischemic brain enhancement on routine CET1-WI seems to be closely related to the luxury reperfusion at the late subacute stage and is not dependent on microvascular permeability changes at the acute stage. ? 2013 American Heart Association, Inc. |
URI: | http://www.scopus.com/inward/record.url?eid=2-s2.0-84879937393&partnerID=MN8TOARS http://scholars.lib.ntu.edu.tw/handle/123456789/380171 |
DOI: | 10.1161/STROKEAHA.113.001558 | SDG/Keyword: | article; blood vessel permeability; brain hemorrhage; brain infarction; brain ischemia; clinical article; contrast enhancement; contrast-enhanced T1-weighted imaging; disease severity; human; middle cerebral artery occlusion; nuclear magnetic resonance imaging; priority journal; reperfusion; blood-brain barrier; Ktrans; parenchymal enhancement; Acute Disease; Adult; Brain Ischemia; Capillary Permeability; Cerebral Hemorrhage; Chronic Disease; Diffusion Magnetic Resonance Imaging; Follow-Up Studies; Humans; Image Enhancement; Infarction, Middle Cerebral Artery; Stroke |
Appears in Collections: | 生醫電子與資訊學研究所 |
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