TY - JOUR
T1 - Contrast leakage distant from the hematoma in patients with spontaneous ICH
T2 - A 7 T MRI study
AU - Jolink, Wilmar MT
AU - Lindenholz, Arjen
AU - van Etten, Ellis S
AU - van Nieuwenhuizen, Koen M
AU - Schreuder, Floris Hbm
AU - Kuijf, Hugo J
AU - van Osch, Matthias Jp
AU - Hendrikse, Jeroen
AU - Rinkel, Gabriel Je
AU - Wermer, Marieke JH
AU - Klijn, Catharina JM
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Klijn is supported by a clinical established investigator grant of the Dutch Heart Foundation (Grant Number 2012T077) and an ASPASIA grant from The Netherlands Organisation for Health Research and Development, ZonMw (grant number 015008048)
Publisher Copyright:
© The Author(s) 2019.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Disruption of the blood-brain barrier (BBB) might play a role in the pathophysiology of cerebral small vessel disease-related ICH. The aim of this study was to assess presence and extent of contrast agent leakage distant from the hematoma as a marker of BBB disruption in patients with spontaneous ICH. We prospectively performed 7 tesla MRI in adult patients with spontaneous ICH and assessed contrast leakage distant from the hematoma on 3D FLAIR images. Thirty-one patients were included (mean age 60 years, 29% women). Median time between ICH and MRI was 20 days (IQR 9-67 days). Seventeen patients (54%; seven lobar, nine deep, one infratentorial ICH) had contrast leakage, located cortical in 16 and cortical and deep in one patient. Patients with contrast leakage more often had lobar cerebral microbleeds (CMBs; 77%) than those without (36%; RR 2.5, 95% CI 1.1-5.7) and a higher number of lobar CMBs (patients with contrast leakage: median 2, IQR 1-8 versus those without: median 0, IQR 0-2; p = 0.02). This study shows that contrast leakage distant from the hematoma is common in days to weeks after spontaneous ICH. It is located predominantly cortical and related to lobar CMBs and therefore possibly to cerebral amyloid angiopathy.
AB - Disruption of the blood-brain barrier (BBB) might play a role in the pathophysiology of cerebral small vessel disease-related ICH. The aim of this study was to assess presence and extent of contrast agent leakage distant from the hematoma as a marker of BBB disruption in patients with spontaneous ICH. We prospectively performed 7 tesla MRI in adult patients with spontaneous ICH and assessed contrast leakage distant from the hematoma on 3D FLAIR images. Thirty-one patients were included (mean age 60 years, 29% women). Median time between ICH and MRI was 20 days (IQR 9-67 days). Seventeen patients (54%; seven lobar, nine deep, one infratentorial ICH) had contrast leakage, located cortical in 16 and cortical and deep in one patient. Patients with contrast leakage more often had lobar cerebral microbleeds (CMBs; 77%) than those without (36%; RR 2.5, 95% CI 1.1-5.7) and a higher number of lobar CMBs (patients with contrast leakage: median 2, IQR 1-8 versus those without: median 0, IQR 0-2; p = 0.02). This study shows that contrast leakage distant from the hematoma is common in days to weeks after spontaneous ICH. It is located predominantly cortical and related to lobar CMBs and therefore possibly to cerebral amyloid angiopathy.
KW - Blood–brain barrier
KW - cerebral microbleeds
KW - intracerebral hemorrhage
KW - magnetic resonance imaging
KW - small vessel disease
KW - Blood-brain barrier
UR - https://www.scopus.com/pages/publications/85067807600
U2 - 10.1177/0271678X19852876
DO - 10.1177/0271678X19852876
M3 - Article
C2 - 31142225
SN - 0271-678X
VL - 40
SP - 1002
EP - 1011
JO - Journal of Cerebral Blood Flow and Metabolism
JF - Journal of Cerebral Blood Flow and Metabolism
IS - 5
ER -