Intracranial Distribution of Intravenously Administered Gadolinium-based Contrast Agent over a Period of 24 Hours: Evaluation with 3D-real IR Imaging and MR Fingerprinting

Naganawa, Shinji; Ito, Rintaro; Kato, Yutaka; Kawai, Hisashi; Taoka, Toshiaki; Yoshida, Tadao; Maruyama, Katsuya; Murata, Katsutoshi; Körzdörfer, Gregor; Pfeuffer, Josef; Nittka, Mathias

doi:10.2463/mrms.mp.2020-0030

Cited by 14 publications

(18 citation statements)

References 46 publications

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“…However, the intrathecal administration of GBCA in humans has not been approved in any country [36]. In this context, several trials have evaluated the glymphatic function through the intravenous administration of GBCA [37][38][39][40][41]. In contrast to the tracer study, including intravenous GBCA, provides information about the tracer's movement as the integral of the elapsed time, and the diffusion method provides information about the tissue water molecules at the moment the MPGs are applied.…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of diffusion tensor image analysis along the perivascular space (DTI-ALPS) for evaluating interstitial fluid diffusivity and glymphatic function: CHanges in Alps index on Multiple conditiON acquIsition eXperiment (CHAMONIX) study

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Purpose The diffusion tensor image analysis along the perivascular space (DTI-ALPS) method was developed to evaluate the brain’s glymphatic function or interstitial fluid dynamics. This study aimed to evaluate the reproducibility of the DTI-ALPS method and the effect of modifications in the imaging method and data evaluation. Materials and methods Seven healthy volunteers were enrolled in this study. Image acquisition was performed for this test–retest study using a fixed imaging sequence and modified imaging methods which included the placement of region of interest (ROI), imaging plane, head position, averaging, number of motion-proving gradients, echo time (TE), and a different scanner. The ALPS-index values were evaluated for the change of conditions listed above. Results This test–retest study by a fixed imaging sequence showed very high reproducibility (intraclass coefficient = 0.828) for the ALPS-index value. The bilateral ROI placement showed higher reproducibility. The number of averaging and the difference of the scanner did not influence the ALPS-index values. However, modification of the imaging plane and head position impaired reproducibility, and the number of motion-proving gradients affected the ALPS-index value. The ALPS-index values from 12-axis DTI and 3-axis diffusion-weighted image (DWI) showed good correlation (r = 0.86). Also, a shorter TE resulted in a larger value of the ALPS-index. Conclusion ALPS index was robust under the fixed imaging method even when different scanners were used. ALPS index was influenced by the imaging plane, the number of motion-proving gradient axes, and TE in the imaging sequence. These factors should be uniformed in the planning ALPS method studies. The possibility to develop a 3-axis DWI-ALPS method using three axes of the motion-proving gradient was also suggested.

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Section: Discussionmentioning

confidence: 99%

Reproducibility of diffusion tensor image analysis along the perivascular space (DTI-ALPS) for evaluating interstitial fluid diffusivity and glymphatic function: CHanges in Alps index on Multiple conditiON acquIsition eXperiment (CHAMONIX) study

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“…3D-real IR imaging is more sensitive than MR fingerprinting to extremely low concentrations of GBCA in fluid. 85 The longitudinal assessment of 3D-real IR images after the intravenous administration of GBCA can help analyze the morphological microstructure of the downstream region and understand the relationship with glymphatic system function. Furthermore, the degree of leakage of GBCA from the subpial space around the cortical veins to the surrounding subarachnoid space observed after intravenous administration of GBCA was shown to be significantly accelerated by aging 86,87 (Fig.…”

Section: Intravenous Administration Of Gbcamentioning

confidence: 99%

“…Meanwhile, it is important in the study of the glymphatic system to elucidate the detailed anatomy of the connections from the perivenous space around the veins in the brain, to the subpial space around the cortical veins, and finally, to meningeal lymphatic vessels. [84][85][86][87] Also, it is crucial to reveal the relationship between cyst formation in the vicinity of these connections and the stagnation of ISF flow. 90 These studies will help us to understand the glymphatic system and the kinetics of drugs in the CNS.…”

Section: Mri Of Glymphatic Systemmentioning

confidence: 99%

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The Glymphatic System: A Review of the Challenges in Visualizing its Structure and Function with MR Imaging

Naganawa

Taoka

2022

MRMS

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The central nervous system (CNS) was previously thought to be the only organ system lacking lymphatic vessels to remove waste products from the interstitial space. Recently, based on the results from animal experiments, the glymphatic system was hypothesized. In this hypothesis, cerebrospinal fluid (CSF) enters the periarterial spaces, enters the interstitial space of the brain parenchyma via aquaporin-4 (AQP4) channels in the astrocyte end feet, and then exits through the perivenous space, thereby clearing waste products. From the perivenous space, the interstitial fluid drains into the subarachnoid space and meningeal lymphatics of the parasagittal dura. It has been reported that the glymphatic system is particularly active during sleep. Impairment of glymphatic system function might be a cause of various neurodegenerative diseases such as Alzheimer's disease, normal pressure hydrocephalus, glaucoma, and others. Meningeal lymphatics regulate immunity in the CNS. Many researchers have attempted to visualize the function and structure of the glymphatic system and meningeal lymphatics in vivo using MR imaging. In this review, we aim to summarize these in vivo MR imaging studies and discuss the significance, current limitations, and future directions. We also discuss the significance of the perivenous cyst formation along the superior sagittal sinus, which is recently discovered in the downstream of the glymphatic system.

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“…Several minutes after intravenous administration (IV) of a gadolinium-based contrast agent (GBCA), the subpial space around the cortical veins is enhanced in human patients. 1,2 In addition, it has been shown that the GBCA often leaks into the surrounding subarachnoid space by 4 hrs after intravenous administration. [3][4][5] It has also been reported that leakage of the GBCA into the subarachnoid space around the cortical veins on 3D real inversion recovery (3D-real IR) images obtained at 4 hrs post-administration is observed frequently in subjects over 37 years of age, but significantly less often in individuals younger than 37 years 3,4 A potential connection between the subpial space around the cortical veins and the presumed meningeal lymphatic vessels on both sides of the superior sagittal sinus [6][7][8] has been reported using MR imaging.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Time-dependent Signal Changes in Parasagittal Perivenous Cysts and Leakage of Gadolinium-based Contrast Agents into the Subarachnoid Space

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To investigate the association between signal changes over time in perivenous cystic structures near the superior sagittal sinus and leakage of a gadolinium-based contrast agent (GBCA) into the subarachnoid space in patients with suspected endolymphatic hydrops. Methods: Fifty-one cystic structures in 27 cases were evaluated. The signal intensity of the cystic structures was measured on 3D real inversion recovery (3D-real IR) images obtained at pre-, and at 10 min, 4 hrs and 24 hrs post-intravenous administration (IV) of GBCA. Signal enhancement of the cystic structures from the pre-contrast images at each time point was compared in subjects with leakage (positive) versus those without leakage (negative) using an ANOVA. Fisher's exact probability test was used to compare the maximum contrast-enhanced time point between positive and negative groups. We used 5% as a threshold to determine statistical significance. Results: In leakage positive subjects, mean signal enhancement of the cysts was significantly greater at 4 and 24 hrs compared to 10 min. However, although there was a trend of an increase from 4 to 24 hrs, the difference was not significant. In the leakage negative group, mean signal enhancement of the cysts was significantly higher at 4 hrs compared to 10 min and 24 hrs. There was no significant difference between 10 min and 24 hrs. In the positive group, the maximum signal increase was found in 10/38 and 28/38 cysts at 4 and 24 hrs after IV-GBCA, respectively. In the leakage negative group, the maximum signal increase was found in 10/13 and 3/13 cysts at 4 and 24 hrs, respectively (P = 0.0019). Conclusion: There was an association between signal changes over time after IV-GBCA in perivenous cystic structures and leakage of GBCA. Further research to clarify the impact of cystic structures on the function of the waste clearance system of the brain is warranted.

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Intracranial Distribution of Intravenously Administered Gadolinium-based Contrast Agent over a Period of 24 Hours: Evaluation with 3D-real IR Imaging and MR Fingerprinting

Cited by 14 publications

References 46 publications

Reproducibility of diffusion tensor image analysis along the perivascular space (DTI-ALPS) for evaluating interstitial fluid diffusivity and glymphatic function: CHanges in Alps index on Multiple conditiON acquIsition eXperiment (CHAMONIX) study

Reproducibility of diffusion tensor image analysis along the perivascular space (DTI-ALPS) for evaluating interstitial fluid diffusivity and glymphatic function: CHanges in Alps index on Multiple conditiON acquIsition eXperiment (CHAMONIX) study

The Glymphatic System: A Review of the Challenges in Visualizing its Structure and Function with MR Imaging

Relationship between Time-dependent Signal Changes in Parasagittal Perivenous Cysts and Leakage of Gadolinium-based Contrast Agents into the Subarachnoid Space

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