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(Stroke. 2007;38:303.)
© 2007 American Heart Association, Inc.

Original Contributions

Inflammatory Response After Ischemic Stroke

A USPIO-Enhanced MRI Study in Patients

Norbert Nighoghossian, MD, PhD; Marlène Wiart, PhD; Serkan Cakmak, MD; Yves Berthezène, MD, PhD; Laurent Derex, MD, PhD; Tae-Hee Cho, MD; Chantal Nemoz, PhD; François Chapuis, MD; Guy-Louis Tisserand, MD; Jean-Baptiste Pialat, MD; Paul Trouillas, MD, PhD; Jean-Claude Froment, MD, PhD Marc Hermier, MD, PhD

From the Hospices Civils de Lyon (N.N., S.C., L.D., T.-H.C., P.T.), Cerebrovascular Unit, Hôpital Neurologique, Lyon, France; Creatis UMR CNRS 5515 INSERM U630 (N.N., M.W., Y.B., L.D., J.-B.P., J.-C.F., M.H.), UCB Lyon, France; Hospices Civils de Lyon (G.-L.T., J.-C.F., M.H.), Service de Radiologie, Hôpital Neurologique, Lyon, France; Laboratoire de Biostatistiques de la Santé (C.N.), UMR CNRS 5558, Lyon, France; and the Département d’Information Médicale (F.C.), Lyon, France.

Correspondence to Prof N. Nighoghossian, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69777 Bron Cedex, France. E-mail norbert.nighoghossian{at}chu-lyon.fr

Background and Purpose— The intensity of the inflammatory response may be related to the volume of acute infarction. Ultra-small superparamagnetic particles of iron oxide (USPIO) may enable assessment of neuroinflammation. We aimed to assess whether the intensity of the inflammatory response might be related to the subacute ischemic lesion volume.

Methods— We enrolled patients who presented with acute anterior circulation stroke. MRI was performed at day 0, day 6, and day 9. The MRI protocol included T1-weighted imaging, gradient-echo T2*-weighted imaging, diffusion-weighted imaging, perfusion-weighted imaging and MR angiography. Blood-brain barrier disruption was defined as post-gadolinium enhancement on T1-weighted images. USPIO was administered after day 6 MRI. USPIO enhancement ratios were defined as the ratio between USPIO-related signal volume on day 9 T1-weighted imaging (respectively T2*-weighted imaging) and day 6 diffusion-weighted imaging infarct volume. The relationship between day 6 infarct volume and the enhancement ratio was assessed using Pearson and Spearman correlation tests.

Results— The protocol was completed in 10 patients. Signal alterations after USPIO injection was observed in 9/10 patients on day 9 T1-weighted imaging and in 5/10 patients on day 9 T2*-weighted imaging. USPIO-related MRI enhancement was heterogeneous. Lesion volume on day 6 diffusion-weighted imaging had no impact on USPIO enhancement at day 9 according to the Pearson correlation test (P=0.39) or Spearman test (P=0.25). There was no relationship between blood-brain barrier disruption and USPIO enhancement.

Conclusions— USPIO MRI enhancement is heterogeneous and not clearly related to subacute lesion volume.

Key Words: acute stroke • brain infarction • inflammation • MRI

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