RT Journal Article SR Electronic T1 MTT and Blood-Brain Barrier Disruption within Asymptomatic Vascular WM Lesions JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 1396 OP 1402 DO 10.3174/ajnr.A7165 VO 42 IS 8 A1 B.E. Dewey A1 X. Xu A1 L. Knutsson A1 A. Jog A1 J.L. Prince A1 P.B. Barker A1 P.C.M. van Zijl A1 R. Leigh A1 P. Nyquist YR 2021 UL http://www.ajnr.org/content/42/8/1396.abstract AB BACKGROUND AND PURPOSE: White matter lesions of presumed ischemic origin are associated with progressive cognitive impairment and impaired BBB function. Studying the longitudinal effects of white matter lesion biomarkers that measure changes in perfusion and BBB patency within white matter lesions is required for long-term studies of lesion progression. We studied perfusion and BBB disruption within white matter lesions in asymptomatic subjects.MATERIALS AND METHODS: Anatomic imaging was followed by consecutive dynamic contrast-enhanced and DSC imaging. White matter lesions in 21 asymptomatic individuals were determined using a Subject-Specific Sparse Dictionary Learning algorithm with manual correction. Perfusion-related parameters including CBF, MTT, the BBB leakage parameter, and volume transfer constant were determined.RESULTS: MTT was significantly prolonged (7.88 [SD, 1.03] seconds) within white matter lesions compared with normal-appearing white (7.29 [SD, 1.14] seconds) and gray matter (6.67 [SD, 1.35] seconds). The volume transfer constant, measured by dynamic contrast-enhanced imaging, was significantly elevated (0.013 [SD, 0.017] minutes−1) in white matter lesions compared with normal-appearing white matter (0.007 [SD, 0.011] minutes−1). BBB disruption within white matter lesions was detected relative to normal white and gray matter using the DSC-BBB leakage parameter method so that increasing BBB disruption correlated with increasing white matter lesion volume (Spearman correlation coefficient = 0.44; P < .046).CONCLUSIONS: A dual-contrast-injection MR imaging protocol combined with a 3D automated segmentation analysis pipeline was used to assess BBB disruption in white matter lesions on the basis of quantitative perfusion measures including the volume transfer constant (dynamic contrast-enhanced imaging), the BBB leakage parameter (DSC), and MTT (DSC). This protocol was able to detect early pathologic changes in otherwise healthy individuals.cSVDcerebrovascular small-vessel diseaseDCEdynamic contrast-enhancedGdgadoliniumK2BBB leakage parameterKtransvolume transfer constantWMLwhite matter lesion