背景:尽管缺血再灌注(I/R)损伤在皮质和皮质下区域之间有所不同,其对特定地区的影响尚不清楚。在这项研究中,我们使用各种磁共振成像(MRI)技术来检查啮齿动物模型的挽救性缺血半暗带(IP)和再灌注性缺血核心(IC)内I/R损伤的时空动力学,目的是通过阐明这些动态来增强治疗策略。
方法:用缝合模型对17只Sprague-Dawley大鼠进行短暂大脑中动脉闭塞1h。MRI,包括扩散张量成像(DTI),T2加权成像,灌注加权成像,和T1映射,在I/R阶段的多个时间点进行长达5天。血脑屏障(BBB)修饰的时空动力学通过IP和IC区域内T1的变化进行表征,并与平均扩散率(MD)进行比较。T2和脑血流量。
结果:在I/R阶段,IC的MD最初下降,再通后归一化,24小时时再次下降,在第五天达到顶峰.相比之下,IP保持相对稳定。IP和IC都表现出过度灌注,IP在24小时达到峰值,其次是决议,而过度灌注在IC中维持到第5天。尽管过度灌注,IP保持完整的BBB,而IC经历持续性BBB渗漏。在24小时,IC表现出T2信号的增加,对应于在5天表现出BBB破坏的区域。
结论:高灌注和BBB损害在IP和IC中具有不同的模式。定量T1作图可以作为早期发现恶性充血伴BBB渗漏的辅助工具。帮助再通后的精确干预。这些发现强调了MRI标记在监测缺血特异性区域和定制治疗策略以改善患者预后方面的价值。
BACKGROUND: Although ischemia-reperfusion (I/R) injury varies between cortical and subcortical regions, its effects on specific regions remain unclear. In this study, we used various magnetic resonance imaging (MRI) techniques to examine the spatiotemporal dynamics of I/R injury within the salvaged ischemic penumbra (IP) and reperfused ischemic core (IC) of a rodent model, with the aim of enhancing therapeutic strategies by elucidating these dynamics.
METHODS: A total of 17 Sprague-Dawley rats were subjected to 1 h of transient middle cerebral artery occlusion with a suture model. MRI, including diffusion tensor imaging (DTI), T2-weighted imaging, perfusion-weighted imaging, and T1 mapping, was conducted at multiple time points for up to 5 days during the I/R phases. The spatiotemporal dynamics of blood-brain barrier (BBB) modifications were characterized through changes in T1 within the IP and IC regions and compared with mean diffusivity (MD), T2, and cerebral blood flow.
RESULTS: During the I/R phases, the MD of the IC initially decreased, normalized after recanalization, decreased again at 24 h, and peaked on day 5. By contrast, the IP remained relatively stable. Both the IP and IC exhibited hyperperfusion, with the IP reaching its peak at 24 h, followed by resolution, whereas hyperperfusion was maintained in the IC until day 5. Despite hyperperfusion, the IP maintained an intact BBB, whereas the IC experienced persistent BBB leakage. At 24 h, the IC exhibited an increase in the T2 signal, corresponding to regions exhibiting BBB disruption at 5 days.
CONCLUSIONS: Hyperperfusion and BBB impairment have distinct patterns in the IP and IC. Quantitative T1 mapping may serve as a supplementary tool for the early detection of malignant hyperemia accompanied by BBB leakage, aiding in precise interventions after recanalization. These findings underscore the value of MRI markers in monitoring ischemia-specific regions and customizing therapeutic strategies to improve patient outcomes.