MRI measurement of blood–brain barrier leakage: minding the gaps

Thrippleton, Michael J.

doi:10.1113/jp277425

Cited by 5 publications

(6 citation statements)

References 6 publications

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“…Currently, dynamic contrast-enhanced (DCE) MRI is considered the most widely used imaging technique for BBB research ( 168 ) since it provides quantitative estimates of contrast agent leakage at moderate spatial resolution. It allows for a quantitative BBBP assessment both in healthy and diseased vessels with an adequate spatial resolution.…”

Section: Blood–barrier Permeability Evaluation In the Early Detectionmentioning

confidence: 99%

Pathophysiology of Blood–Brain Barrier Permeability Throughout the Different Stages of Ischemic Stroke and Its Implication on Hemorrhagic Transformation and Recovery

et al. 2020

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The blood–brain barrier (BBB) is a dynamic interface responsible for maintaining the central nervous system homeostasis. Its unique characteristics allow protecting the brain from unwanted compounds, but its impairment is involved in a vast number of pathological conditions. Disruption of the BBB and increase in its permeability are key in the development of several neurological diseases and have been extensively studied in stroke. Ischemic stroke is the most prevalent type of stroke and is characterized by a myriad of pathological events triggered by an arterial occlusion that can eventually lead to fatal outcomes such as hemorrhagic transformation (HT). BBB permeability seems to follow a multiphasic pattern throughout the different stroke stages that have been associated with distinct biological substrates. In the hyperacute stage, sudden hypoxia damages the BBB, leading to cytotoxic edema and increased permeability; in the acute stage, the neuroinflammatory response aggravates the BBB injury, leading to higher permeability and a consequent risk of HT that can be motivated by reperfusion therapy; in the subacute stage (1–3 weeks), repair mechanisms take place, especially neoangiogenesis. Immature vessels show leaky BBB, but this permeability has been associated with improved clinical recovery. In the chronic stage (>6 weeks), an increase of BBB restoration factors leads the barrier to start decreasing its permeability. Nonetheless, permeability will persist to some degree several weeks after injury. Understanding the mechanisms behind BBB dysregulation and HT pathophysiology could potentially help guide acute stroke care decisions and the development of new therapeutic targets; however, effective translation into clinical practice is still lacking. In this review, we will address the different pathological and physiological repair mechanisms involved in BBB permeability through the different stages of ischemic stroke and their role in the development of HT and stroke recovery.

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Section: Blood–barrier Permeability Evaluation In the Early Detectionmentioning

confidence: 99%

Pathophysiology of Blood–Brain Barrier Permeability Throughout the Different Stages of Ischemic Stroke and Its Implication on Hemorrhagic Transformation and Recovery

et al. 2020

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“…Their observation shows significant differences in gray matter and white matter, and the ratio of GM/WM cerebral blood flow was reported near-pathological results. DCEMRI technique revealed faster leakage in GM compared with WM in healthy controls and suggested that perfusion has a greater value in GM that corresponds to higher vascular surface area per unit tissue volume, so it has an important role in the measurement of Ktrans ( Thrippleton, 2019 ; van Horssen, Brink, de Vries, van der Valk, & Bø, 2007 ; Varatharaj, Liljeroth, M., Darekar, Larsson, Galea, & Cramer, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Quantification of Blood-Brain-Barrier Permeability Dysregulation and Inflammatory Activity in MS Lesions by Dynamic-Contrast Enhanced MR Imaging

Oghabian

Fatemidokht

Haririchian

2022

BCN

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Objective: Measurement of blood-brain permeability dysfunction in active and chronic MS lesions with T1-weighted dynamic contrast-enhanced MRI to show variation in inflammatory activity Background: blood-brain-barrier perfusion characterization impaired in MS as some studies have shown recently buta comparison between perfusion parameters in contrast-enhanced and non-enhanced lesions not have been well documented. Pharmacokinetic quantitative parameters have obtained from dynamic contrast-enhanced in magnetic resonance imaging is a useful way to quantify blood-brain barrier permeability leakage. Material and methods: MR examination was performed on 28 patients with Relapsing-remitted multiple sclerosis (RRMS) with (mean age=34.7 ±9.28) which had multiple lesions in the brain.3D dynamic T1-weighted spoiled gradient echo was obtained and Perfusion parameters and its map assessed in enhanced and non-enhanced lesions after intravascular injection differences in parameters and map obtained by analyzing ROI in Extended Toft model. Results: permeability as measured Krtans was a significantly higher value in CE to compare NE lesions. Ktrans and Kep have significant differences in NAWM and CE and NE lesions. Vb was slightly different in NE and CE lesions. Conclusion: Permeability measured as Ktrans was the good parameter to show permeability impairment of BBB in CE lesions. Dysregulation in BBB is an acceptable sign to indicate existence inflammation in CE lesions.

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“…The main output measure is the BBB leakage rate K trans , which is the product of the vessel surface area (S) and the permeability (P). 113 An additional output measure of this model is the blood volume fraction ( v b ).…”

Section: Mri Methods To Measure Microvascular Rarefactionmentioning

confidence: 99%

Assessment of microvascular rarefaction in human brain disorders using physiological magnetic resonance imaging

Dinther

Voorter

Jansen

et al. 2022

J Cereb Blood Flow Metab

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Cerebral microvascular rarefaction, the reduction in number of functional or structural small blood vessels in the brain, is thought to play an important role in the early stages of microvascular related brain disorders. A better understanding of its underlying pathophysiological mechanisms, and methods to measure microvascular density in the human brain are needed to develop biomarkers for early diagnosis and to identify targets for disease modifying treatments. Therefore, we provide an overview of the assumed main pathophysiological processes underlying cerebral microvascular rarefaction and the evidence for rarefaction in several microvascular related brain disorders. A number of advanced physiological MRI techniques can be used to measure the pathological alterations associated with microvascular rarefaction. Although more research is needed to explore and validate these MRI techniques in microvascular rarefaction in brain disorders, they provide a set of promising future tools to assess various features relevant for rarefaction, such as cerebral blood flow and volume, vessel density and radius and blood-brain barrier leakage.

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MRI measurement of blood–brain barrier leakage: minding the gaps

Cited by 5 publications

References 6 publications

Pathophysiology of Blood–Brain Barrier Permeability Throughout the Different Stages of Ischemic Stroke and Its Implication on Hemorrhagic Transformation and Recovery

Pathophysiology of Blood–Brain Barrier Permeability Throughout the Different Stages of Ischemic Stroke and Its Implication on Hemorrhagic Transformation and Recovery

Quantification of Blood-Brain-Barrier Permeability Dysregulation and Inflammatory Activity in MS Lesions by Dynamic-Contrast Enhanced MR Imaging

Assessment of microvascular rarefaction in human brain disorders using physiological magnetic resonance imaging

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