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Updated: Mar 9, 2026
An In Vivo Assessment of Blood-Brain Barrier Disruption in a Rat Model of Ischemic Stroke
Published on: March 11, 2018
DCE-MRI blood-brain barrier assessment in acute ischemic stroke
Kersten Villringer1, Borja E Sanz Cuesta2, Ann-Christin Ostwaldt2
1From 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.
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 Ktrans values (0.7 × 10-3 min-1 [interquartile range (IQR) 0.4-1.8] × 10-3 min-1) were more than 3-fold higher compared to median mirror Ktrans values (0.2 × 10-3 min-1, IQR 0.1-0.7 × 10-3 min-1, p < 0.001) and further increased at follow-up (n = 28, 2.3 × 10-3 min-1, IQR 0.8-4.6 × 10-3 min-1, p < 0.001). By contrast, mirror Ktrans values decreased over time with a clear interaction of timepoint and stroke/mirror side (p < 0.001). Median stroke Ktrans values were 2.5 times lower than in hemorrhagic transformed regions (0.7 vs 1.8 × 10-3 min-1; p = 0.055). There was no association between stroke Ktrans values and the delay from symptom onset to baseline examination, age, and presence of hyperintense acute reperfusion marker.
Conclusion:
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.
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