Early Blood Brain Barrier Changes in Acute Ischemic Stroke: A Sequential MRI Study
Marc Giraud
Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorTae-Hee Cho
Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorCorresponding Author
Norbert Nighoghossian
Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Correspondence: Address correspondence to N. Nighoghossian, MD, PhD, Centre d'Urgences Cerebrovasculaires, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, GHE, 59 Bd Pinel, 69677 Bron, France. E-mail: [email protected].Search for more papers by this authorDelphine Maucort-Boulch
Department of Biostatistics, Hospices Civils de Lyon, Lyon, France, CNRS UMR 5558, Equipe Biostatistique Santé, Pierre-Bénite, France, Université Lyon I, Villeurbanne, France
Search for more papers by this authorGianluca Deiana
Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorLeif Østergaard
Department of Neuroradiology, Center of Functionally Integrative Neuroscience, Århus University, Århus, Denmark
Search for more papers by this authorJean-Claude Baron
Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK, Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France
Search for more papers by this authorJens Fiehler
Departments of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Search for more papers by this authorSalvador Pedraza
Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain
Search for more papers by this authorLaurent Derex
Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorYves Berthezène
Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorMarc Giraud
Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorTae-Hee Cho
Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorCorresponding Author
Norbert Nighoghossian
Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Correspondence: Address correspondence to N. Nighoghossian, MD, PhD, Centre d'Urgences Cerebrovasculaires, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, GHE, 59 Bd Pinel, 69677 Bron, France. E-mail: [email protected].Search for more papers by this authorDelphine Maucort-Boulch
Department of Biostatistics, Hospices Civils de Lyon, Lyon, France, CNRS UMR 5558, Equipe Biostatistique Santé, Pierre-Bénite, France, Université Lyon I, Villeurbanne, France
Search for more papers by this authorGianluca Deiana
Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorLeif Østergaard
Department of Neuroradiology, Center of Functionally Integrative Neuroscience, Århus University, Århus, Denmark
Search for more papers by this authorJean-Claude Baron
Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK, Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France
Search for more papers by this authorJens Fiehler
Departments of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Search for more papers by this authorSalvador Pedraza
Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain
Search for more papers by this authorLaurent Derex
Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorYves Berthezène
Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France
Search for more papers by this authorNo disclosure.
No conflict of interest.
ABSTRACT
BACKGROUND AND PURPOSE
We sought to identify MRI factors associated with BBB changes at the acute stage of ischemic stroke.
METHODS
We analyzed BBB changes on admission and within 3 hours after the first scan. BBB changes was defined as the presence of leptomeningeal and parenchymal contrast enhancement on T1-weighted imaging. Tmax, CBV, and DWI lesion volume were assessed on baseline MRI. Clinical and MRI factors associated with BBB changes were assessed by univariate and multivariate logistic regressions analyses.
RESULTS
Forty-four patients were included. BBB changes on baseline MRI was observed in 2 of 44 patients (3%). BBB disruption on H3-MRI was present in 19 of 44 patients (43%). Hemodynamic status and baseline ischemic core size were not different between patients with or without BBB changes. BBB alteration on H3 MRI was strongly associated with FLAIR MRI sequence positivity, 16/19 patients (83%) P = .001.
CONCLUSION
BBB changes are exceptional during the first 3 hours after stroke onset. Delayed BBB alteration was associated with FLAIR positivity mainly reflecting vasogenic edema.
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