Published Online
on August 23, 2007

A more recent version of this article appeared on October 1, 2007

This Article Full Text (PDF) All Versions of this Article: 38/10/2733    most recent STROKEAHA.107.481788v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Saleh, A. Articles by Jander, S. Search for Related Content PubMed PubMed Citation Articles by Saleh, A. Articles by Jander, S. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Encephalitis MRI Scans Stroke Hazardous Substances DB IRON Related Collections Acute Cerebral Infarction Computerized tomography and Magnetic Resonance Imaging

Submitted on January 5, 2007
Revised on March 5, 2007
Accepted on March 27, 2007

Iron Oxide Particle-Enhanced MRI Suggests Variability of Brain Inflammation at Early Stages After Ischemic Stroke

Andreas Saleh MD; Michael Schroeter MD; Adrian Ringelstein MD; Hans-Peter Hartung MD; Mario Siebler MD; Ulrich Mödder MD; and Sebastian Jander MD^*

From the Institute of Diagnostic Radiology (A.S., A.R., U.M.), and the Department of Neurology (M. Schroeter, H.P.H., M. Siebler, S.J.), Heinrich-Heine-University, Düsseldorf, Germany.

^* To whom correspondence should be addressed. E-mail: jander{at}uni-duesseldorf.de.

Background and Purpose—Inflammation contributes to brain damage caused by ischemic stroke. Ultrasmall superparamagnetic iron oxide (USPIO)-enhanced MRI allows noninvasive monitoring of macrophage recruitment into ischemic brain lesions. In this study, we determined the extent of USPIO enhancement during early stages of ischemic stroke.

Methods—Twelve consecutive patients with typical clinical signs of stroke underwent multimodal stroke imaging at 1.5-T within 24 hours of symptom onset. They received intravenous USPIO (ferumoxtran) infusion at 26 to 96 hours (mean, 44 hours) after stroke. A total of four follow-up MRI scans were performed 24 to 36 hours, 48 to 72 hours, 7 to 8 days, and 10 to 11 days after USPIO infusion.

Results—Nine patients were included in the final analysis. Parenchymal USPIO enhancement occurred in 3 of 9 analyzed patients and was mainly evident on T1-weighted spin-echo images. USPIO-dependent signal changes were spatially heterogeneous, reflecting the distinct patterns of hematogenous macrophage infiltration in different lesion types.

Conclusions—Our findings suggest a variable extent and distribution of macrophage infiltration into early ischemic stroke lesions. USPIO-enhanced MRI may help to more specifically target antiinflammatory therapy in patients with stroke.

Key words: inflammation • macrophages • magnetic resonance imaging • stroke • USPIO

This article has been cited by other articles:

				V. Desestret, J.-C. Brisset, S. Moucharrafie, E. Devillard, S. Nataf, J. Honnorat, N. Nighoghossian, Y. Berthezene, and M. Wiart Early-Stage Investigations of Ultrasmall Superparamagnetic Iron Oxide-Induced Signal Change After Permanent Middle Cerebral Artery Occlusion in Mice Stroke, May 1, 2009; 40(5): 1834 - 1841. [Abstract] [Full Text] [PDF]

				M. O. Breckwoldt, J. W. Chen, L. Stangenberg, E. Aikawa, E. Rodriguez, S. Qiu, M. A. Moskowitz, and R. Weissleder Tracking the inflammatory response in stroke in vivo by sensing the enzyme myeloperoxidase PNAS, November 25, 2008; 105(47): 18584 - 18589. [Abstract] [Full Text] [PDF]