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

Jonathan J Russin; Axel Montagne; Francesco D'Amore; Shuhan He; Mark S Shiroishi; Robert C Rennert; Jena Depetris; Berislav V Zlokovic; William J Mack

doi:10.1177/0271678X18768670

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

Jonathan J Russin, Axel Montagne, Francesco D'Amore, Shuhan He, Mark S Shiroishi, Robert C Rennert, Jena Depetris, Berislav V Zlokovic, William J Mack

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

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 ( Ktrans) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10-3 min-1) compared to those who experienced radiographic vasospasm only (three patients; 1.85 ± 0.12 × 10-3 min-1; p < 0.05), or no vasospasm/ischemia (eight patients; 1.74 ± 0.07 × 10-3 min-1; p < 0.01). Ktrans > 2 × 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.

Original language	English
Pages (from-to)	973-979
Number of pages	7
Journal	Journal of Cerebral Blood Flow and Metabolism
Volume	38
Issue number	6
DOIs	https://doi.org/10.1177/0271678X18768670
Publication status	Published - Jun 2018

Keywords / Materials (for Non-textual outputs)

Adult
Aged
Aged, 80 and over
Blood-Brain Barrier/diagnostic imaging
Brain Ischemia/diagnostic imaging
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Permeability
Predictive Value of Tests
Subarachnoid Hemorrhage/diagnostic imaging
Vasospasm, Intracranial/diagnostic imaging

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10.1177/0271678X18768670

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title = "Permeability imaging as a predictor of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage",

abstract = "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 ( Ktrans) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10-3 min-1) compared to those who experienced radiographic vasospasm only (three patients; 1.85 ± 0.12 × 10-3 min-1; p < 0.05), or no vasospasm/ischemia (eight patients; 1.74 ± 0.07 × 10-3 min-1; p < 0.01). Ktrans > 2 × 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.",

keywords = "Adult, Aged, Aged, 80 and over, Blood-Brain Barrier/diagnostic imaging, Brain Ischemia/diagnostic imaging, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Permeability, Predictive Value of Tests, Subarachnoid Hemorrhage/diagnostic imaging, Vasospasm, Intracranial/diagnostic imaging",

author = "Russin, {Jonathan J} and Axel Montagne and Francesco D'Amore and Shuhan He and Shiroishi, {Mark S} and Rennert, {Robert C} and Jena Depetris and Zlokovic, {Berislav V} and Mack, {William J}",

year = "2018",

month = jun,

doi = "10.1177/0271678X18768670",

language = "English",

volume = "38",

pages = "973--979",

journal = "Journal of Cerebral Blood Flow and Metabolism",

issn = "1559-7016",

publisher = "LIPPINCOTT-RAVEN PUBL",

number = "6",

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TY - JOUR

T1 - Permeability imaging as a predictor of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

AU - Russin, Jonathan J

AU - Montagne, Axel

AU - D'Amore, Francesco

AU - He, Shuhan

AU - Shiroishi, Mark S

AU - Rennert, Robert C

AU - Depetris, Jena

AU - Zlokovic, Berislav V

AU - Mack, William J

PY - 2018/6

Y1 - 2018/6

N2 - 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 ( Ktrans) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10-3 min-1) compared to those who experienced radiographic vasospasm only (three patients; 1.85 ± 0.12 × 10-3 min-1; p < 0.05), or no vasospasm/ischemia (eight patients; 1.74 ± 0.07 × 10-3 min-1; p < 0.01). Ktrans > 2 × 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.

AB - 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 ( Ktrans) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10-3 min-1) compared to those who experienced radiographic vasospasm only (three patients; 1.85 ± 0.12 × 10-3 min-1; p < 0.05), or no vasospasm/ischemia (eight patients; 1.74 ± 0.07 × 10-3 min-1; p < 0.01). Ktrans > 2 × 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.

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KW - Aged

KW - Aged, 80 and over

KW - Blood-Brain Barrier/diagnostic imaging

KW - Brain Ischemia/diagnostic imaging

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Permeability

KW - Predictive Value of Tests

KW - Subarachnoid Hemorrhage/diagnostic imaging

KW - Vasospasm, Intracranial/diagnostic imaging

U2 - 10.1177/0271678X18768670

DO - 10.1177/0271678X18768670

M3 - Article

C2 - 29611451

SN - 1559-7016

VL - 38

SP - 973

EP - 979

JO - Journal of Cerebral Blood Flow and Metabolism

JF - Journal of Cerebral Blood Flow and Metabolism

IS - 6

ER -

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

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Keywords / Materials (for Non-textual outputs)

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