Time‐efficient measurement of subtle blood–brain barrier leakage using a T<sub>1</sub> mapping MRI protocol at 7 T

Kerkhof, Marieke van den; Voorter, Paulien H.M.; Canjels, L.P.W.; Jong, Joost J.A. de; Oostenbrugge, Robert J. van; Kroon, Abraham A.; Jansen, Jacobus F. A.; Backes, Walter H.

doi:10.1002/mrm.28629

Cited by 6 publications

(6 citation statements)

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“…Therefore, we obtained the VIF from the SSS, which was previously found favorable due to a higher consistency 36 . The latter study using 7T DCE‐MRI showed comparable K i and v p values of WM and GM with our current study 37 . Note that the study by van den Kerkhof et al.…”

Section: Discussionsupporting

confidence: 70%

“…Previously, with data acquired at 3T, more accurate leakage results could be obtained with such long acquisition times, 19,41 and most current DCE‐MRI studies at 3T have acquisition times between 20 and 30 min, 6,11,18,31 similar to our continuous sampling DCE‐MRI sequence at 7T. Also, in another 7T MRI study, it was shown that a sparsely time‐sampled DCE‐MRI protocol with a time interval of approximately 20 min could detect subtle BBB leakage 37 . In the future, the sensitivity for detecting subtle BBB leakage at shorter acquisition times should also be investigated with our continuously sampling DCE‐MRI protocol to see whether the acquisition time can be shortened.…”

Section: Discussionmentioning

confidence: 58%

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7T dynamic contrast‐enhanced MRI for the detection of subtle blood–brain barrier leakage

Canjels

Jansen

Kerkhof

et al. 2021

Journal of Neuroimaging

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Background and Purpose Dynamic contrast‐enhanced MRI (DCE‐MRI) can be employed to assess the blood–brain barrier (BBB) integrity. Detection of BBB leakage at lower field strengths (≤3T) is cumbersome as the signal is noisy, while leakage can be subtle. Utilizing the increased signal‐to‐noise ratio at higher field strengths, we explored the application of 7T DCE‐MRI for assessing BBB leakage. Methods A dual‐time resolution DCE‐MRI method was implemented at 7T and a slow injection rate (0.3 ml/s) and low dose (3 mmol) served to obtain signal changes linearly related to the gadolinium concentration, that is, minimized for T2* degradation effects. With the Patlak graphical approach, the leakage rate (Ki) and blood plasma volume fraction (vp) were calculated. The method was evaluated in 10 controls, an ischemic stroke patient, and a patient with a transient ischemic attack. Results Ki and vp were significantly higher in gray matter compared to white matter of all participants. These Ki values were higher in both patients compared to the control subjects. Finally, for the lesion identified in the ischemic stroke patient, higher leakage values were observed compared to normal‐appearing tissue. Conclusion We demonstrate how a dual‐time resolution DCE‐MRI protocol at 7T, with administration of half the clinically used contrast agent dose, can be used for assessing subtle BBB leakage. Although the feasibility of DCE‐MRI for assessing the BBB integrity at 3T is well known, we showed that a continuous sampling DCE‐MRI method tailored for 7T is also capable of assessing leakage with a high sensitivity over a range of Ki values.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 58%

7T dynamic contrast‐enhanced MRI for the detection of subtle blood–brain barrier leakage

Canjels

Jansen

Kerkhof

et al. 2021

Journal of Neuroimaging

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“…More details about the scan parameters and this protocol are reported in Table S1 and Kerkhof et al (2021). 11 For optimal segmentation of grey matter (GM) and white matter (WM), a T2-weighted fluid–attenuated inversion recovery (FLAIR) sequence (TR/TE/TI = 8000/303/2330 ms; cubic voxel size: 1 mm, acquisition time: 6:59 min:s) was acquired in between the two postcontrast T1-maps. Additionally, for the rating of microbleeds and perivascular spaces (PVS), a susceptibility weighted imaging (SWI) sequence was acquired before contrast administration, and T2-weighted images were acquired after contrast administration, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, we proposed a highly sensitive DCE-method at 7 Tesla, where instead of the commonly continuously acquired T1-weighted images, only two quantitative post-contrast T1-maps were acquired. 11 In the current study, we investigated the relation between hypertension, blood pressure and BBB leakage in human subjects. Therefore, we applied the sparsely time-sampled, dynamic contrast-enhanced MRI protocol to patients with essential hypertension and normotensive, healthy controls, to investigate group differences in BBB leakage rates.…”

Section: Introductionmentioning

confidence: 99%

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Blood-brain barrier integrity decreases with higher blood pressure, a 7T DCE-MRI study

van den Kerkhof,

de Jong,

Voorter

et al. 2024

Preprint

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BackgroundBlood-brain barrier (BBB) integrity is presumed to be impaired in hypertension, resulting from cerebral endothelial dysfunction. Hypertension antedates various cerebrovascular diseases, such as cerebral small vessel disease (cSVD), and is a risk factor for developing neurodegenerative diseases for which BBB disruption is a preceding pathophysiological process. In this study, we investigated the relation between hypertension, current blood pressure and BBB leakage in human subjects.MethodsBBB leakage was determined in twenty-two patients with hypertension and nineteen normotensive controls, age- and sex-matched (median age[range]:65[45-80] years,19 males), using a sparsely time-sampled contrast-enhanced 7 Tesla MRI protocol. Structural cSVD markers were visually rated. Multivariable regression analyses, adjusted for age, sex, cardiovascular risk factors and cSVD markers, were performed to determine the relation between hypertension status, systolic and diastolic blood pressure (SBP and DBP), mean arterial pressure (MAP), drug treatment, and BBB leakage.ResultsBoth hypertensive and normotensive participants showed mild scores of cSVD. BBB leakage did not differ between hypertensive and normotensive participants, however was significantly higher for SBP, DBP and MAP in the cortex, and DBP and MAP in the grey matter. Effectively treated patients showed less BBB leakage than those with current hypertension.ConclusionBBB integrity in the total and cortical grey matter decreases with increasing blood pressure, but is not related to hypertension status. These findings show that BBB disruption already occurs with increasing blood pressure, before the presence of overt cerebral tissue damage. Additionally, our results suggest that effective antihypertensive medication has a protective effect on the BBB.Registered at:https://trialsearch.who.int/; Unique identifier: NL7537

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Linking peripheral atherosclerosis to blood–brain barrier disruption: elucidating its role as a manifestation of cerebral small vessel disease in vascular cognitive impairment

Nyúl-Tóth,

Patai,

Csiszar

et al. 2024

GeroScience

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Aging plays a pivotal role in the pathogenesis of cerebral small vessel disease (CSVD), contributing to the onset and progression of vascular cognitive impairment and dementia (VCID). In older adults, CSVD often leads to significant pathological outcomes, including blood–brain barrier (BBB) disruption, which in turn triggers neuroinflammation and white matter damage. This damage is frequently observed as white matter hyperintensities (WMHs) in neuroimaging studies. There is mounting evidence that older adults with atherosclerotic vascular diseases, such as peripheral artery disease, ischemic heart disease, and carotid artery stenosis, face a heightened risk of developing CSVD and VCID. This review explores the complex relationship between peripheral atherosclerosis, the pathogenesis of CSVD, and BBB disruption. It explores the continuum of vascular aging, emphasizing the shared pathomechanisms that underlie atherosclerosis in large arteries and BBB disruption in the cerebral microcirculation, exacerbating both CSVD and VCID. By reviewing current evidence, this paper discusses the impact of endothelial dysfunction, cellular senescence, inflammation, and oxidative stress on vascular and neurovascular health. This review aims to enhance understanding of these complex interactions and advocate for integrated approaches to manage vascular health, thereby mitigating the risk and progression of CSVD and VCID.

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Time‐efficient measurement of subtle blood–brain barrier leakage using a T₁ mapping MRI protocol at 7 T

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 39 publications

7T dynamic contrast‐enhanced MRI for the detection of subtle blood–brain barrier leakage

7T dynamic contrast‐enhanced MRI for the detection of subtle blood–brain barrier leakage

Blood-brain barrier integrity decreases with higher blood pressure, a 7T DCE-MRI study

Linking peripheral atherosclerosis to blood–brain barrier disruption: elucidating its role as a manifestation of cerebral small vessel disease in vascular cognitive impairment

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Time‐efficient measurement of subtle blood–brain barrier leakage using a T1 mapping MRI protocol at 7 T

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 39 publications

7T dynamic contrast‐enhanced MRI for the detection of subtle blood–brain barrier leakage

7T dynamic contrast‐enhanced MRI for the detection of subtle blood–brain barrier leakage

Blood-brain barrier integrity decreases with higher blood pressure, a 7T DCE-MRI study

Linking peripheral atherosclerosis to blood–brain barrier disruption: elucidating its role as a manifestation of cerebral small vessel disease in vascular cognitive impairment

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Time‐efficient measurement of subtle blood–brain barrier leakage using a T₁ mapping MRI protocol at 7 T