title: Early prediction of functional outcome using dynamic contrast enhanced magnetic resonance imaging in experimental stroke.
abstract: Early prediction of functional outcome in cerebral ischemia stroke using MRI remains a challenge. The aim of this study was to evaluate the predictive value of dynamic contrast-enhanced (DCE) MRI in terms of functional outcome of ischemia stroke.
  
  
  
  Right middle cerebral artery occlusion (MCAO) was performed in male SD rats (n=50), followed by withdrawal of the occluding filament after 3 (n = 10), 4 (n = 10), 5 (n = 10), 6 (n = 10) or 7 (n = 10) h to establish ischemia and reperfusion stroke. DCE and conventional MRI were performed in each animal 60 ± 15 min before and after reperfusion. The outcome was assessed by the modified Neurological Severity Scores (mNSS) (before reperfusion and at 72 h after reperfusion) and the infarct volume. Comparisons of functional prognosis and DCE parameters (K(trans), Ve and Kep) were performed using binary logistic regression and operating characteristic (ROC) analysis.
  
  
  
  DCE parameters results indicated that blood brain barrier (BBB) permeability increased with prolonged reperfusion timing. Using binary logistic regression analysis on stroke characteristics (reperfusion timing, infarct volume) and BBB permeability parameters (drK(trans)subcortex, drK(trans)cortex, drVesubcortex, drVecortex, drKepsubcortex and drKepcortex) as covariates , the results demonstrated that reperfusion timing, infarct volume, drK(trans)subcortex and drKepsubcortex were independent factors that were associated with prognosis (OR=0.01, OR=0.23, OR=245.23, OR=1.29). ROC analysis indicated that a drK(trans)subcortex threshold of 0.88 with a sensitivity of 95.7% and a specificity of 85.2% and a drKepsubcortex threshold of -0.25 with a sensitivity of 69.6% and a specificity of 70.4% for differentiation between favourable and unfavourable prognosis.
  
  
  
  Quantitative DCE-MRI can be used to predict the functional outcomes of cerebral ischemia injury.
authors.affiliation: Department of Radiology, Hainan General Hospital, Haikou, Hainan Province, China.
authors.forename: Wei-Yuan
authors.initials: WY
authors.lastname: Huang
authors.affiliation: Department of Radiotherapy, Hainan General Hospital, Haikou, Hainan Province, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Radiology, Hainan General Hospital, Haikou, Hainan Province, China. Electronic address: lijianjunhngh@163.com.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Li
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: gengdaoying2245@163.com.
authors.forename: Dao-Ying
authors.initials: DY
authors.lastname: Geng
authors.affiliation: Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
authors.forename: Wen-Li
authors.initials: WL
authors.lastname: Tan
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Xiang-Rong
authors.initials: XR
authors.lastname: Yu
mesh_terms: D000818:Animals; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology; D003287:Contrast Media; D004195:Disease Models, Animal; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology*
chemical_list: D003287:Contrast Media
keywords: Blood–Brain barrier; Dynamic contrast enhanced; Ischemia–Reperfusion injury; Magnetic resonance imaging; Middle cerebral artery occlusion; Prognosis