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Contrast-enhanced MRI of white matter lesions in patients with blood-brain barrier dysfunction
1Department of Radiology, Huddinge University Hospital, Sweden. lars-olof.wahlund@neurotec.ki.se
Abstract:
White matter lesions (WMLs) and blood-brain barrier (BBB) dysfunction are common in dementia. Both conditions may be a consequence of small-vessel disease, in which case the BBB damage could be suspected to be located to the WMLs. Magnetic resonance imaging (MRI) can be used to show WMLs as well as to detect BBB damage when using an intravenous contrast agent, gadolinium. We examined 10 demented patients with WMLs, including 5 cases with BBB (elevated CSF/serum albumin ratios). Results showed no significant changes in MR signal in the WMLs after contrast administration. We conclude that WMLs are not related to BBB damage to such a degree that is detectable with this method and that the elevated CSF albumin might have another origin.
Insights
White matter lesions (WMLs) in dementia are not linked to blood-brain barrier (BBB) damage detectable by MRI contrast agents. Elevated cerebrospinal fluid albumin in some patients may stem from other causes, not WMLs.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Dementia Research
Background:
- White matter lesions (WMLs) and blood-brain barrier (BBB) dysfunction are prevalent in dementia patients.
- These conditions are often associated with underlying small-vessel disease.
- BBB damage is hypothesized to occur within WMLs.
Purpose of the Study:
- To investigate the relationship between WMLs and BBB damage in patients with dementia.
- To determine if BBB dysfunction is localized to WMLs using MRI contrast enhancement.
Main Methods:
- Magnetic resonance imaging (MRI) was employed to visualize WMLs.
- Intravenous gadolinium contrast agent was administered to detect BBB leakage.
- Cerebrospinal fluid (CSF) and serum albumin ratios were measured to assess BBB integrity.
Main Results:
- No significant MRI signal changes were observed in WMLs after contrast administration.
- The study included 10 demented patients with WMLs, 5 of whom had elevated CSF/serum albumin ratios.
Conclusions:
- WMLs in dementia are not associated with BBB damage detectable by current MRI contrast methods.
- Elevated CSF albumin levels in these patients likely originate from sources other than WML-related BBB breakdown.