- Title
- Reperfusion facilitates reversible disruption of the human blood-brain barrier following acute ischaemic stroke
- Creator
- Liu, Chang; Zhang, Sheng; Yan, Shenqiang; Zhang, Ruiting; Shi, Feina; Ding, Xinfa; Parsons, Mark; Lou, Min
- Relation
- European Radiology Vol. 28, Issue 2, p. 642-649
- Publisher Link
- http://dx.doi.org/10.1007/s00330-017-5025-3
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2018
- Description
- Objectives: We aimed to detect early changes of the blood-brain barrier permeability (BBBP) in acute ischaemic stroke (AIS), with or without reperfusion, and find out whether BBBP can predict clinical outcomes. Methods: Consecutive AIS patients imaged with computed tomographic perfusion (CTP) before and 24 h after treatment were included. The relative permeability-surface area product (rPS) was calculated within the hypoperfused region (rPShypo-i), non-hypoperfused region of ischaemic hemisphere (rPSnonhypo-i) and their contralateral mirror regions (rPShypo-c and rPSnonhypo-c). The changes of rPS were analysed using analysis of variance (ANOVA) with repeated measures. Logistic regression was used to identify independent predictors of unfavourable outcome. Results: Fifty-six patients were included in the analysis, median age was 76 (IQR 62-81) years and 28 (50%) were female. From baseline to 24 h after treatment, rPShypo-i, rPSnonhypo-i and rPShypo-c all decreased significantly. The decreases in rPShypo-i and rPShypo-c were larger in the reperfusion group than non-reperfusion group. The rPShypo-i at follow-up was a predictor for unfavourable outcome (OR 1.131; 95% CI 1.018-1.256; P = 0.022). Conclusion: Early disruption of BBB in AIS is reversible, particularly when greater reperfusion is achieved. Elevated BBBP at 24 h after treatment, not the pretreatment BBBP, predicts unfavourable outcome. Key points: Early disruption of blood-brain barrier (BBB) in stroke is reversible after treatment; The reversibility of BBB permeability is associated with reperfusion; Unfavourable outcome is associated with BBB permeability at 24 h after treatment; Contralateral non-ischaemic hemisphere is not 'normal' during an acute stroke.
- Subject
- blood-brain barrier; computed tomography; outcome; reperfusion; stroke
- Identifier
- http://hdl.handle.net/1959.13/1414404
- Identifier
- uon:36740
- Identifier
- ISSN:0938-7994
- Language
- eng
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