Abstract T P27: Early Blood Brain Barrier Disruption in the Ischemic Core
Background: Animal models of cerebral ischemia have identified an early, reversible opening of the blood brain barrier (BBB) which is separate from the delayed secondary opening caused by neuroinflamation. A recent study found BBB disruption was frequently detected in acute ischemic stroke patients with MRI permeability imaging (Leigh et al., Stroke, 2014).
Hypothesis: More severe restricted diffusion will be associated with higher degrees of BBB damage in acute ischemic stroke patients.
Methods: The MRI scans of 13 acute ischemic stroke patients were analyzed. Diffusion weighted images (DWI) and perfusion weighted images (PWI) where co-registered to allow for a voxel based analysis. Blood-brain permeability images (BBPI) were generated from the PWI source images as described in the aforementioned study. Only voxels of tissue which had an apparent diffusion coefficient (ADC) < 700 were included. Linear regression was performed to determine if there was a relationship between ADC and BBPI.
Results: From the 13 patients, 535 mL of brain tissue was included in the analysis. The figure shows a scatter plot and regression line of ADC value vs mean fraction of gadolinium leakage on BBPI. Univariate linear regression with ADC as the independent variable and BBPI as the dependent variable found them to be significantly correlated (p<0.001). Multivariate analysis found time-to-MRI (p<0.001) but not patient age (p=0.71) to be significantly correlated with BBPI in addition to ADC (p<0.001).
Conclusions: Early BBB damage was detected within the ischemic core of acute stroke patients. The degree of restricted diffusion was significantly correlated with the degree of BBB damage.
Author Disclosures: R. Leigh: None.
- © 2015 by American Heart Association, Inc.