Permeability imaging as a predictor of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

被引：27
|
作者：
Russin, Jonathan J. [1 ,4 ]
Montagne, Axel [2 ]
D'Amore, Francesco [3 ]
He, Shuhan [2 ]
Shiroishi, Mark S. [3 ]
Rennert, Robert C. [1 ]
Depetris, Jena [2 ]
Zlokovic, Berislav V. [2 ]
Mack, William J. [2 ,4 ]
机构：
[1] Univ Southern Calif, Keck Sch Med, USC Neurorestorat Ctr, 1200 N State St,Suite 3300, Los Angeles, CA 90033 USA
[2] Univ Southern Calif, Keck Sch Med, Zilkha Neurogenet Inst, Los Angeles, CA 90033 USA
[3] Univ Southern Calif, Keck Sch Med, Dept Radiol, Los Angeles, CA 90033 USA
[4] Univ Southern Calif, Keck Sch Med, Dept Neurol Surg, Los Angeles, CA 90033 USA
来源：
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM | 2018年 / 38卷 / 06期
关键词：
Delayed cerebral ischemia; subarachnoid hemorrhage; dynamic contrast-enhanced magnetic resonance imaging; aneurysm; blood-brain barrier; BLOOD-BRAIN-BARRIER; INTERCELLULAR-ADHESION MOLECULE-1; TIME-COURSE; CT ANGIOGRAPHY; ACUTE STAGE; VASOSPASM; INHIBITOR; MATRIX-METALLOPROTEINASE-9; INFLAMMATION; DISRUPTION;
D O I：
10.1177/0271678X18768670
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Blood-brain barrier (BBB) dysfunction has been implicated in ischemic risk following aneurysmal subarachnoid hemorrhage (aSAH), but never directly imaged. We prospectively examined whether post-bleed day 4 dynamic contrast-enhanced magnetic resonance (DCE-MR) BBB permeability imaging could predict development of delayed cerebral ischemia (DCI). Global MR-derived BBB permeability (K-trans) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 +/- 0.09 x 10(-3) min(-1)) compared to those who experienced radiographic vasospasm only (three patients; 1.85 +/- 0.12 x 10(-3) min(-1); p<0.05), or no vasospasm/ischemia (eight patients; 1.74 +/- 0.07x 10(-3) min(-1); p < 0.01). K-trans > 2 x 10(-3) min(-1) predicted development of DCI (AUC = 0.98, 95% CI: 0.93-1). Global BBB dysfunction following aSAH is detectable with DCE-MR and predictive of ischemic risk.
引用
收藏
页码：973 / 979
页数：7
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