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Updated: Mar 21, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Early prediction of functional outcome using dynamic contrast enhanced magnetic resonance imaging in experimental
Wei-Yuan Huang1, Gang Wu2, Jian-Jun Li1
1Department of Radiology, Hainan General Hospital, Haikou, Hainan Province, China.
Background And Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
Quantitative DCE-MRI can be used to predict the functional outcomes of cerebral ischemia injury.
Insights
Dynamic contrast-enhanced MRI effectively predicts functional outcomes in cerebral ischemia stroke. Key parameters like blood-brain barrier permeability, identified through quantitative analysis, correlate with stroke prognosis.
Area of Science:
- Neurology
- Radiology
- Biomedical Engineering
Background:
- Predicting functional outcomes in cerebral ischemia stroke using MRI is challenging.
- Dynamic contrast-enhanced (DCE) MRI offers potential for early functional outcome prediction.
Purpose of the Study:
- To evaluate the predictive value of DCE MRI for functional outcomes in ischemia stroke.
- To correlate DCE MRI parameters with neurological severity and infarct volume.
Main Methods:
- Male SD rats underwent middle cerebral artery occlusion (MCAO) with varying reperfusion times (3-7 hours).
- DCE and conventional MRI were performed before and after reperfusion.
- Functional outcome assessed via modified Neurological Severity Scores (mNSS) and infarct volume; analyzed using logistic regression and ROC analysis.
Main Results:
- Blood-brain barrier (BBB) permeability increased with prolonged reperfusion.
- Reperfusion timing, infarct volume, and BBB permeability (drK(trans)subcortex, drKepsubcortex) were independent predictors of prognosis.
- Specific thresholds for drK(trans)subcortex and drKepsubcortex differentiated favorable from unfavorable outcomes with high sensitivity and specificity.
Conclusions:
- Quantitative DCE-MRI is a valuable tool for predicting functional outcomes in cerebral ischemia.
- DCE MRI parameters provide insights into BBB integrity and its relation to stroke prognosis.
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