Quantification of brain edema and hemorrhage by MRI after experimental traumatic brain injury in rabbits predicts subsequent functional outcome

Li, Yuehua; Wang, Jianbo; Li, Minghua; Li, Wenbin; Wang, Dan

doi:10.1007/s10072-011-0768-0

Cited by 12 publications

(8 citation statements)

References 48 publications

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“…IgG expression was used as an indirect indicator of the degree of damage to the blood–brain barrier, with increased IgG expression indicative of vasogenic edema 22. Detection of blood–brain barrier permeability facilitates accurate clinical prognosis 23. Strong positive (+++) expression of IgG at 1, 12, and 48 h suggests remarkable breakdown of the blood–brain barrier and vasogenic edema.…”

Section: Discussionmentioning

confidence: 99%

Dynamic features of brain edema in rat models of traumatic brain injury

Ren

2019

NeuroReport

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We explored the dynamic features of brain edema after traumatic brain injury (TBI) using healthy adult male Wistar rats. After inducing moderate brain injuries in the rats, we divided them randomly among seven groups on the basis of the time elapsed between TBI and examination: 1, 6, 12, 24, 48, 72, and 168 h. All rats were scanned using diffusion-weighted imaging (DWI) to observe tissue changes in the contusion penumbra (CP) after TBI. Immunoglobulin G expression was also detected. At 1 h after TBI, there was an annular light-colored region in the CP where the intercellular space was enlarged, suggesting vasogenic edema. At 6 h, the cells expanded, their nuclei shrank, and the cytoplasm was replaced by vacuoles, indicating intracellular edema. Vasogenic edema and intracellular edema increased 12 h after TBI, but decreased 24 h after TBI, with vasogenic edema increasing 48 h after TBI. By 72 h after TBI, intracellular edema dominated until resolution of all edema by 168 h after TBI. DWI indicated that the relative apparent diffusion coefficient increased markedly at 1 h after TBI, but was reduced at 6 and 12 h after TBI. At 48 h, relative apparent diffusion coefficient increased gradually and then declined at 72 h. In rats, TBI-related changes include dynamic variations in intracellular and vasogenic edema severity. Routine MRI and DWI examinations do not distinguish between the center of trauma and CP; however, the apparent diffusion coefficient diagram can portray variations in CP edema type and degree at different time-points following TBI.

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Section: Discussionmentioning

confidence: 99%

Dynamic features of brain edema in rat models of traumatic brain injury

Ren

2019

NeuroReport

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“…T2W MR data of cortical lesions can be correlated with histologic lesion volume, neurofunction, and allow a distinction of mild and severe TBI of rats ( 9 , 10 ). Furthermore, this multiparametric quantitative MRI show the potential to predict the functional and histopathological outcome for 6 and 12 months after injury ( 12 , 13 ) and findings can be correlated with the state of cerebral energy metabolites of focal and diffuse TBI ( 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Multimodal MR imaging of acute and subacute experimental traumatic brain injury: Time course and correlation with cerebral energy metabolites

Maegele

Hoeffgen

Uhlenkueken

et al. 2015

Acta Radiologica Short Reports

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BackgroundTraumatic brain injury (TBI) is one of the leading causes of death and permanent disability world-wide. The predominant cause of death after TBI is brain edema which can be quantified by non-invasive diffusion-weighted magnetic resonance imaging (DWI).PurposeTo provide a better understanding of the early onset, time course, spatial development, and type of brain edema after TBI and to correlate MRI data and the cerebral energy state reflected by the metabolite adenosine triphosphate (ATP).Material and MethodsThe spontaneous development of lateral fluid percussion-induced TBI was investigated in the acute (6 h), subacute (48 h), and chronic (7 days) phase in rats by MRI of quantitative T2 and apparent diffusion coefficient (ADC) mapping as well as perfusion was combined with ATP-specific bioluminescence imaging and histology.ResultsAn induced TBI led to moderate to mild brain damages, reflected by transient, pronounced development of vasogenic edema and perfusion reduction. Heterogeneous ADC patterns indicated a parallel, but mixed expression of vasogenic and cytotoxic edema. Cortical ATP levels were reduced in the acute and subacute phase by 13% and 27%, respectively, but were completely normalized at 7 days after injury.ConclusionThe partial ATP reduction was interpreted to be partially caused by a loss of neurons in parallel with transient dilution of the regional ATP concentration by pronounced vasogenic edema. The normalization of energy metabolism after 7 days was likely due to infiltrating glia and not to recovery. The MRI combined with metabolite measurement further improves the understanding and evaluation of brain damages after TBI.

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“…Animal models of TBI have suggested that initial hemorrhage volume can be used as a predictor of long-term outcome. 13,20 However, there has been little studied on the evolution of traumatic parenchymal hemorrhage and its relationship with outcome in a longitudinal manner.…”

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confidence: 99%

Traumatic hemorrhagic brain injury: impact of location and resorption on cognitive outcome

Martin

Wright

Lutkenhoff³

et al. 2017

JNS

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OBJECTIVE Hemorrhagic contusions are often the most visible lesions following traumatic brain injury. However, the incidence, location, and natural history of traumatic parenchymal hemorrhage and its impact on neurological outcome have been understudied. The authors sought to examine the location and longitudinal evolution of traumatic parenchymal hemorrhage and its association with cognitive outcome. METHODS Sixteen patients with hemorrhagic contusions due to acceleration-deceleration injuries underwent MRI in the acute (mean 6.3 days postinjury) and chronic (mean 192.9 days postinjury) phases. ImageJ was used to generate GRE and FLAIR volumes. To account for the effect of head-size variability across individuals, the authors calculated each patient's total brain tissue volume using SIENAX. GRE and FLAIR volumes were normalized to the total brain tissue volume, and values for absolute and percent lesion volume and total brain volume change were generated. Spearman's rank correlations were computed to determine associations between neuroimaging and 6-month postinjury neuropsychological testing of attention (Symbol Digit Modalities Test [SDMT], oral [O] and written [W] versions), memory (Selective Reminding Test, total learning and delayed recall), and executive function (Trail Making Test Part B [TMT-B]). RESULTS The patients' mean age was 31.4 ± 14.0 years and their mean Glasgow Coma Scale score at admission was 7.9 ± 2.8. Lesions were predominantly localized to the frontal (11 lesions) and temporal (9 lesions) lobes. The average percent reductions in GRE and FLAIR volumes were 44.2% ± 46.1% and 80.5% ± 26.3%, respectively. While total brain and frontal lesion volumes did not correlate with brain atrophy, larger temporal lobe GRE and FLAIR volumes were associated with larger volumes of atrophy (GRE: acute, −0.87, p < 0.01, chronic, −0.78, p < 0.01; FLAIR: acute, −0.81, p < 0.01, chronic, −0.88, p < 0.01). Total percent volume change of GRE lesions correlated with TMT-B (0.53, p < 0.05) and SDMT-O (0.62, p < 0.05) scores. Frontal lobe lesion volume did not correlate with neuropsychological outcome. However, robust relationships were seen in the temporal lobe, with larger acute temporal lobe GRE volumes were associated with worse scores on both oral and written versions of the SDMT (SDMT-W, −0.85, p < 0.01; SDMT-O, −0.73, p < 0.05). Larger absolute change in temporal GRE volume was strongly associated with worse SDMT scores (SDMT-W, 0.88, p < 0.01; SDMT-O, 0.75, p < 0.05). The same relationships were also seen between temporal FLAIR lesion volumes and neuropsychological outcome. CONCLUSIONS Traumatic parenchymal hemorrhages are largely clustered in the frontal and temporal lobes, and significant residual blood products are present at 6 months postinjury, a potential source of ongoing secondary brain injury. Neuropsychological outcome is closely tied to lesion volume size, particularly in the temporal lobe, where larger GRE and FLAIR volumes are associated with more brain atrophy and worse SDMT scores. Interestingly, larger volumes of hemorrhage resorption were associated with worse SDMT and TMT-B scores, suggesting that the initial tissue damage had a lasting impact on attention and executive function.

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Quantification of brain edema and hemorrhage by MRI after experimental traumatic brain injury in rabbits predicts subsequent functional outcome

Cited by 12 publications

References 48 publications

Dynamic features of brain edema in rat models of traumatic brain injury

Dynamic features of brain edema in rat models of traumatic brain injury

Multimodal MR imaging of acute and subacute experimental traumatic brain injury: Time course and correlation with cerebral energy metabolites

Traumatic hemorrhagic brain injury: impact of location and resorption on cognitive outcome

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