Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.
J Cereb Blood Flow Metab. 2013 Jun;33(6):898-905. doi: 10.1038/jcbfm.2013.27. Epub 2013 Mar 6.
Insufficient vascular reserve after an ischemic stroke may induce biochemical cascades that subsequently deteriorate the blood-brain barrier (BBB) function. However, the direct relationship between poor cerebral blood volume (CBV) restoration and BBB disruption has not been examined in acute stroke. To quantify BBB integrity at acute stages of transient stroke, in particular for cases in which extravasation of the standard contrast agent (Gd-DTPA) is not observed, we adopted the water exchange index (WEI), a novel magnetic resonance image-derived parameter to estimate the water permeability across the BBB. The apparent diffusion coefficient (ADC) and R2 relaxation rate constant were also measured for outlining the tissue abnormality, while fractional CBV and WEI were quantified for assessing vascular alterations. The significantly decreased ADC and R2 in the ischemic cortices did not correlate with the changes in CBV or WEI. In contrast, a strong negative correlation between the ipsilesional WEI and CBV was found, in which stroke mice were clustered into two groups: (1) high WEI and low CBV and (2) normal WEI and CBV. The low CBV observed for mice with a disrupted BBB, characterized by a high WEI, indicates the importance of CBV restoration for maintaining BBB stability in acute stroke.
缺血性脑卒中后血管储备不足可能会引发生化级联反应,进而导致血脑屏障 (BBB) 功能恶化。然而,在急性脑卒中患者中,尚未研究脑血容量 (CBV) 恢复不良与 BBB 破坏之间的直接关系。为了在短暂性脑卒中的急性阶段定量评估 BBB 的完整性,特别是对于那些没有观察到标准造影剂(钆-DTPA)外渗的情况,我们采用了水交换指数 (WEI),这是一种新的磁共振成像衍生参数,用于估计 BBB 两侧的水通透性。还测量了表观扩散系数 (ADC) 和 R2 弛豫率常数以描绘组织异常,同时量化了分数 CBV 和 WEI 以评估血管变化。缺血皮质中的 ADC 和 R2 显著降低与 CBV 变化无关。相比之下,在 ipsilesional WEI 和 CBV 之间发现了很强的负相关,其中脑卒中小鼠被分为两组:(1) 高 WEI 和低 CBV,(2) 正常 WEI 和 CBV。对于 BBB 破坏的小鼠,观察到低 CBV,其特征是高 WEI,这表明在急性脑卒中期间,CBV 恢复对于维持 BBB 稳定性非常重要。