RT Journal Article
SR Electronic
T1 An In Vivo, MRI-Integrated Real-Time Model of Active Contrast Extravasation in Acute Intracerebral Hemorrhage
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1693
OP 1699
DO 10.3174/ajnr.A3939
VO 35
IS 9
A1 R.I. Aviv
A1 T. Huynh
A1 Y. Huang
A1 D. Ramsay
A1 P. Van Slyke
A1 D. Dumont
A1 P. Asmah
A1 R. Alkins
A1 R. Liu
A1 K. Hynynen
YR 2014
UL http://www.ajnr.org/content/35/9/1693.abstract
AB BACKGROUND AND PURPOSE: The “spot sign” or contrast extravasation is strongly associated with hematoma formation and growth. An animal model of contrast extravasation is important to test existing and novel therapeutic interventions to inform present and future clinical studies. The purpose of this study was to create an animal model of contrast extravasation in acute intracerebral hemorrhage. MATERIALS AND METHODS: Twenty-eight hemispheres of Yorkshire male swine were insonated with an MR imaging–guided focused sonography system following lipid microsphere infusion and mean arterial pressure elevation. The rate of contrast leakage was quantified by using dynamic contrast-enhanced MR imaging and was classified as contrast extravasation or postcontrast leakage by using postcontrast T1. Hematoma volume was measured on gradient recalled-echo MR imaging performed 2 hours postprocedure. Following this procedure, sacrificed brain was subjected to histopathologic examination. Power level, burst length, and blood pressure elevation were correlated with leakage rate, hematoma size, and vessel abnormality extent. RESULTS: Median (intracerebral hemorrhage) contrast extravasation leakage was higher than postcontrast leakage (11.3; 6.3–23.2 versus 2.4; 1.1–3.1 mL/min/100 g; P < .001). Increasing burst length, gradient recalled-echo hematoma (ρ = 0.54; 95% CI, 0.2–0.8; P = .007), and permeability were correlated (ρ = 0.55; 95% CI, 0.1–0.8; P = .02). Median permeability (P = .02), gradient recalled-echo hematoma (P = .02), and dynamic contrast-enhanced volumes (P = .02) were greater at 1000 ms than at 10 ms. Within each burst-length subgroup, incremental contrast leakage was seen with mean arterial pressure elevation (ρ = 0.2–0.8). CONCLUSIONS: We describe a novel MR imaging–integrated real-time swine intracerebral hemorrhage model of acute hematoma growth and contrast extravasation. CEcontrast extravasationDCEdynamic contrast-enhancedGREgradient recalled-echoICHintracerebral hemorrhageIQRinterquartile rangeKPSrate of leakageMAPmean arterial pressure elevationPCLpostcontrast leakage