Published Online
on January 22, 2004

A more recent version of this article appeared on February 1, 2004

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Submitted on September 14, 2003
Accepted on October 27, 2003

Noninvasive Quantification of Brain Edema and the Space-Occupying Effect in Rat Stroke Models Using Magnetic Resonance Imaging

T. Gerriets MD^*; E. Stolz MD; M. Walberer DVM; C. Müller PhD; A. Kluge MD; A. Bachmann BS; M. Fisher MD; M. Kaps MD; and G. Bachmann MD

From the Department of Radiology/Experimental Neurology Research Group, Kerckhoff Klinik Bad Nauheim, Bad Nauheim, Germany (T.G., M.W., C.M., A.K., G.B.); Departments of Neurology (T.G., E.S., M.W., M.K.) and Biology (A.B.), University Giessen, Giessen, Germany; and Department of Neurology, University of Massachusetts Medical School, Worcester (M.F.).

^* To whom correspondence should be addressed. E-mail: Tibo.Gerriets{at}neuro.med.uni-giessen.de.

Background and Purpose--Brain edema is a life-threatening consequence of stroke and leads to an extension of the affected tissue. The space-occupying effect due to brain edema can be quantified in rat stroke models with the use of MRI. The present study was performed to test 2 hypotheses: (1) Can quantification of the space-occupying effect due to brain edema serve as a noninvasive measure for brain water content? (2) Does morphometric assessment of brain swelling allow determination of true infarct size on MRI after correction for the space-occupying effect of edema?

Methods--Thirty rats were subjected to permanent suture middle cerebral artery occlusion. MRI was performed after 6 or 24 hours, and hemispheric swelling was assessed morphometrically. Interobserver and intraobserver agreements were determined for MRI measurements. In study I, the space-occupying effect due to brain edema was correlated with the absolute brain water content by the wet/dry method. In study II, lesion volumes corrected and uncorrected for edema were calculated on MRI and on TTC staining and compared.

Results--Interobserver and intraobserver agreements for MRI measurements were excellent (r0.97). Brain water content and hemispheric swelling correlated well after 6 and 24 hours (r0.95). Corrected lesion volumes correlated with r=0.78 between TTC staining and MRI. Without edema correction, lesion volumes were overestimated by 20.3% after 6 hours and by 29.6% after 24 hours of ischemia.

Conclusions--Morphometric assessment of hemispheric swelling on MRI can determine the increase in absolute brain water content noninvasively and can also provide ischemic lesion volumes corrected for brain edema.

Key words: brain edema • cerebral infarction • magnetic resonance imaging • stroke, experimental

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