title: DCE-MRI blood-brain barrier assessment in acute ischemic stroke.
abstract: OBJECTIVE
  To quantitatively evaluate blood-brain barrier changes in ischemic stroke patients using dynamic contrast-enhanced (DCE) MRI.
  
  
  METHODS
  We examined 54 stroke patients (clinicaltrials.gov NCT00715533, NCT02077582) in a 3T MRI scanner within 48 hours after symptom onset. Twenty-eight patients had a follow-up examination on day 5-7. DCE T1 mapping and Patlak analysis were employed to assess BBB permeability changes.
  
  
  RESULTS
  Median stroke Ktransvalues (0.7 × 10-3min-1[interquartile range (IQR) 0.4-1.8] × 10-3min-1) were more than 3-fold higher compared to median mirror Ktransvalues (0.2 × 10-3min-1, IQR 0.1-0.7 × 10-3min-1, p < 0.001) and further increased at follow-up (n = 28, 2.3 × 10-3min-1, IQR 0.8-4.6 × 10-3min-1, p < 0.001). By contrast, mirror Ktransvalues decreased over time with a clear interaction of timepoint and stroke/mirror side (p < 0.001). Median stroke Ktransvalues were 2.5 times lower than in hemorrhagic transformed regions (0.7 vs 1.8 × 10-3min-1; p = 0.055). There was no association between stroke Ktransvalues and the delay from symptom onset to baseline examination, age, and presence of hyperintense acute reperfusion marker.
  
  
  CONCLUSIONS
  BBB in acute stroke patients can be successfully assessed quantitatively. The decrease of BBB permeability in unaffected regions at follow-up may be an indicator of global BBB leakage even in vessel territories remote from the index infarct.
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain. kersten.villringer@charite.de.
authors.forename: Kersten
authors.initials: K
authors.lastname: Villringer
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Borja E
authors.initials: BE
authors.lastname: Sanz Cuesta
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Ostwaldt
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Grittner
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Peter
authors.initials: P
authors.lastname: Brunecker
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Khalil
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Kristina
authors.initials: K
authors.lastname: Schindler
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Ole
authors.initials: O
authors.lastname: Eisenblätter
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Audebert
authors.affiliation: From the Center for Stroke Research (K.V., A.-C.O., U.G., P.B., A.A.K., K.S., O.E., H.A., J.B.F.), Department of Biostatistics and Clinical Epidemiology (U.G.), NeuroCure Cluster of Excellence (A.A.K.), and Department of Neurology (H.A.), Charite-Universitätsmedizin, Berlin, Germany; and Department of Neurology and Stroke Center (B.E.S.C.), La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Spain.
authors.forename: Jochen B
authors.initials: JB
authors.lastname: Fiebach
mesh_terms: D000368:Aged; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002199:Capillary Permeability / Q000502:physiology; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D003287:Contrast Media