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DCE-MRI blood–brain barrier assessment in acute ischemic stroke
Abstract
Objective To quantitatively evaluate blood-brain barrier changes in ischemic stroke patients using dynamic contrast-enhanced (DCE) MRI. Methods We examined 54 stroke patients (clinicaltrials.gov NCT00715533, NCT02077582) in a 3T MRI scanner within 48 hours after symptom onset. Twenty-eight patients had a follow-up examination on day 5-7. DCE T1 mapping and Patlak analysis were employed to assess BBB permeability changes. Results Median stroke K trans values (0.7 × 10 -3 min -1 [interquartile range (IQR) 0.4-1.8] × 10 -3 min -1 ) were more than 3-fold higher compared to median mirror K trans values (0.2 × 10 -3 min -1 , IQR 0.1-0.7 × 10 -3 min -1 , p -3 min -1 , IQR 0.8-4.6 × 10 -3 min -1 , p trans values decreased over time with a clear interaction of timepoint and stroke/mirror side (p trans values were 2.5 times lower than in hemorrhagic transformed regions (0.7 vs 1.8 × 10 -3 min -1 ; p = 0.055). There was no association between stroke K trans values and the delay from symptom onset to baseline examination, age, and presence of hyperintense acute reperfusion marker. Conclusion BBB in acute stroke patients can be successfully assessed quantitatively. The decrease of BBB permeability in unaffected regions at follow-up may be an indicator of global BBB leakage even in vessel territories remote from the index infarct.
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“Disruption of the BBB, using techniques such as osmotic disruption, biochemical disruption, and ultrasound-mediated disruption, is effective to introduce drugs into the brain; however, these transient BBB openings also allows for the leakage of plasma proteins into the brain, leading to neurotoxicity, vascular pathology, and chronic neuropathologic changes in the brain (1, 7, 11).”
From Neurotransmitter-derived lipidoids (NT-lipidoids) for enhanced brain delivery through intravenous injection (2020) · cites this paper as [11]
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“Disruption of the BBB, using techniques such as osmotic disruption, biochemical disruption, and ultrasound-mediated disruption, is effective to introduce drugs into the brain; however, these transient BBB openings also allows for the leakage of plasma proteins into the brain, leading to neurotoxicity, vascular pathology, and chronic neuropathologic changes in the brain (1, 7, 11).”
From Neurotransmitter-derived lipidoids (NT-lipidoids) for enhanced brain delivery through intravenous injection (2020) · cites this paper as [11]
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Metadata
- Authors
- Villringer, K., Sanz Cuesta, B. E., Ostwaldt, A.-C., Grittner, U., Brunecker, P., Khalil, A. A., Schindler, K., Eisenblätter, O., Audebert, H., & Fiebach, J. B.
- Affiliations
- Hospital La Paz Institute for Health Research (ES)
- From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
- ORCID
- Venue
- Neurology
- Published
- 2017-01-31
- Volume
- 88
- Issue
- 5
- Pages
- 433-440
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2567404406
- Cited by
- 119
- References
- 37
- Citations by year
- 2026: 13 · 2025: 17 · 2024: 10 · 2023: 15 · 2022: 7 · 2021: 26 · 2020: 15 · 2019: 9 · 2018: 5 · 2017: 2
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- blood-brain barrier permeability, acute ischemic stroke, dynamic contrast-enhanced MRI, Patlak analysis, Ktrans, hemorrhagic transformation, reperfusion, T1 mapping
- MeSH terms
- Aged, Blood-Brain Barrier, Capillary Permeability, Brain Ischemia, Contrast Media, Female, Follow-Up Studies, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Male, Stroke
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