title: Early Blood Brain Barrier Changes in Acute Ischemic Stroke: A Sequential MRI Study.
abstract: OBJECTIVE
  We sought to identify MRI factors associated with BBB changes at the acute stage of ischemic stroke.
  
  
  METHODS
  We analyzed BBB changes on admission and within 3 hours after the first scan. BBB changes was defined as the presence of leptomeningeal and parenchymal contrast enhancement on T1-weighted imaging. Tmax , CBV, and DWI lesion volume were assessed on baseline MRI. Clinical and MRI factors associated with BBB changes were assessed by univariate and multivariate logistic regressions analyses.
  
  
  RESULTS
  Forty-four patients were included. BBB changes on baseline MRI was observed in 2 of 44 patients (3%). BBB disruption on H3-MRI was present in 19 of 44 patients (43%). Hemodynamic status and baseline ischemic core size were not different between patients with or without BBB changes. BBB alteration on H3 MRI was strongly associated with FLAIR MRI sequence positivity, 16/19 patients (83%) P = .001.
  
  
  CONCLUSIONS
  BBB changes are exceptional during the first 3 hours after stroke onset. Delayed BBB alteration was associated with FLAIR positivity mainly reflecting vasogenic edema.
authors.affiliation: Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Giraud
authors.affiliation: Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France.
authors.forename: Tae-Hee
authors.initials: TH
authors.lastname: Cho
authors.affiliation: Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Nighoghossian
authors.affiliation: Department of Biostatistics, Hospices Civils de Lyon, Lyon, France, CNRS UMR 5558, Equipe Biostatistique Santé, Pierre-Bénite, France, Université Lyon I, Villeurbanne, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Maucort-Boulch
authors.affiliation: Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Deiana
authors.affiliation: Department of Neuroradiology, Center of Functionally Integrative Neuroscience, Århus University, Århus, Denmark.
authors.forename: Leif
authors.initials: L
authors.lastname: Østergaard
authors.affiliation: Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK, Centre de Psychiatrie & Neurosciences, Inserm U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Baron
authors.affiliation: Departments of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Fiehler
authors.affiliation: Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Pedraza
authors.affiliation: Department of Stroke Medicine, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Derex
authors.affiliation: Department of Neuroradiology, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSA-Lyon, Hospices Civils de Lyon, Lyon, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Berthezène
mesh_terms: D000368:Aged; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging*; D013997:Time Factors
keywords: Blood brain barrier; MRI; ischemic stroke