Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea; Department of Radiology, Weill Cornell Medicine, New York, NY, USA.
Research Equipment Operations Division, Korea Basic Science Institute, Cheongju 28119, South Korea.
J Stroke Cerebrovasc Dis. 2023 Aug;32(8):107200. doi: 10.1016/j.jstrokecerebrovasdis.2023.107200. Epub 2023 Jun 7.
The importance of monitoring cerebrospinal fluid for the development of edema in ischemic stroke has been emphasized; however, studies on the relationship between intraventricular cerebrospinal fluid behavior and edema through longitudinal observations and analysis are rare. This study aimed to investigate the correlation between the development of cytotoxic edema and cerebrospinal fluid volume and flow in the third ventricle after ischemic stroke.
The ventricle and edema regions were obtained using apparent diffusion coefficients and T and subdivided into lateral/ventral 3rd ventricles and cytotoxic/vasogenic (or cyst) edema, respectively. In rat models of ischemic stroke, the volume and flow (via the pseudo-diffusion coefficient [D*]) of the ventricles and edema volumes were longitudinally monitored for up to 45 days after surgery.
The volume of cytotoxic edema increased in the hyperacute and acute phases, whereas the volume (r = -0.49) and median D* values (r = -0.48 in the anterior-posterior direction) of the ventral 3rd ventricle both decreased, showing negative correlations with the volume of cytotoxic edema. In contrast, the volume of vasogenic edema/cyst was positively correlated with the volume (r = 0.73) and median D* values (r = 0.78 in the anterior-posterior direction) of the lateral ventricle in the subacute and chronic phases.
This study showed that the evolution of cerebrospinal fluid volume and flow in the ventricles was associated with edema progression at different time points in the ischemic stroke brain. This provides an efficient framework for monitoring and quantifying the interplay between cerebrospinal fluid and edema.
已经强调了监测脑脊髓液对于缺血性中风水肿发展的重要性；然而，通过纵向观察和分析研究脑室脑脊髓液行为与水肿之间的关系的研究很少。本研究旨在探讨缺血性中风后第三脑室细胞毒性水肿与脑脊髓液体积和流量之间的相关性。
使用表观扩散系数和 T2 获得脑室和水肿区域，并将其分为外侧/腹侧第三脑室和细胞毒性/血管源性（或囊）水肿。在缺血性中风大鼠模型中，在手术后长达 45 天的时间内，对脑室和水肿体积的体积和流量（通过假性扩散系数[D*]）进行了纵向监测。
细胞毒性水肿的体积在超急性期和急性期增加，而腹侧第三脑室的体积（r=-0.49）和中位数 D值（前-后方向 r=-0.48）均降低，与细胞毒性水肿的体积呈负相关。相比之下，血管源性水肿/囊的体积与侧脑室的体积（亚急性期和慢性期 r=0.73）和中位数 D值（前-后方向 r=0.78）呈正相关。
本研究表明，脑室中脑脊髓液体积和流量的演变与缺血性中风脑不同时间点的水肿进展有关。这为监测和量化脑脊髓液和水肿之间的相互作用提供了有效的框架。
