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Hachenberger M, Braun T, Gerner ST, Suenner L, Schänzer A, Juenemann M, Mueller C, Wietelmann A, Stolz E, Schoenburg M, Tschernatsch M, Gerriets T, Huttner HB, Yeniguen M. Aluminium Chloride instead of Ferric chloride for inducing superior sagittal sinus thrombosis to reduce ferromagnetic artifacts on MRI-imaging in experimental models. Sci Rep 2024; 14:10998. [PMID: 38745068 PMCID: PMC11094183 DOI: 10.1038/s41598-024-61885-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
Using ferric chloride (FeCl3) to induce experimental superior sagittal sinus (SSS) thrombosis might interfere with magnetic resonance imaging (MRI)-assisted visualization and evaluation of the thrombus, the brain parenchyma, and the quality of the occlusion. The aim of this study was to investigate whether aluminum chloride (AlCl3)-induced thrombosis of the SSS has comparable properties to those of FeCl3 without causing artifacts in MRI. SSS thrombosis was induced in 14 male Wistar rats by exposure of the SSS and subsequent topical application of a filter paper strip soaked in AlCl3 (n = 7) or FeCl3 (n = 7) over a period of 15 min. The animals with AlCl3-induced SSS thrombosis showed a constant and complete occlusion with in histological analysis large thrombi. Blood flow measurements indicated a significant reduction on the first and seventh postoperative day compared to preoperative measurements. MRI enabled visualization and subsequent evaluation of the thrombus and the surrounding parenchyma. In comparison, FeCl3-induced SSS thrombosis could not be evaluated by MRI due to artifacts caused by the paramagnetic properties and increased susceptibility of FeCl3. The occluded sinus and the surrounding area appeared hypointense. The quality of SSS occlusion by AlCl3 was comparable to that of FeCl3. AlCl3 therefore represents a significant alternative substance in experimental SSS thrombosis ideally suited for studies using MRI.
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Affiliation(s)
- Maaike Hachenberger
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Heart and Brain Research Group, 35385, Giessen, Germany
| | - Tobias Braun
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany.
- Heart and Brain Research Group, 35385, Giessen, Germany.
- Department of Neurology, Lahn-Dill-Kliniken Wetzlar, 35578, Wetzlar, Germany.
| | - Stefan T Gerner
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus-Liebig-University Giessen, 35032, Marburg, Germany
| | - Laura Suenner
- Heart and Brain Research Group, 35385, Giessen, Germany
| | - Anne Schänzer
- Institute of Neuropathology, Justus-Liebig University Giessen, 35385, Giessen, Germany
| | - Martin Juenemann
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Heart and Brain Research Group, 35385, Giessen, Germany
| | - Clemens Mueller
- Department of Radiology, Kerckhoff-Klinik Bad Nauheim, 61231, Bad Nauheim, Germany
| | - Astrid Wietelmann
- Scientific Service Group Magnetic Resonance Imaging, Max Planck Institute for Heart and Lung Research, 61231, Bad Nauheim, Germany
| | - Erwin Stolz
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Heart and Brain Research Group, 35385, Giessen, Germany
| | - Markus Schoenburg
- Heart and Brain Research Group, 35385, Giessen, Germany
- Department of Cardiac Surgery, Kerckhoff-Klinik Bad Nauheim, 61231, Bad Nauheim, Germany
| | - Marlene Tschernatsch
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Heart and Brain Research Group, 35385, Giessen, Germany
- Die Neurologen, Private Practice, Frankfurter Strasse 34, 61231, Bad Nauheim, Germany
| | - Tibo Gerriets
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Heart and Brain Research Group, 35385, Giessen, Germany
- Die Neurologen, Private Practice, Frankfurter Strasse 34, 61231, Bad Nauheim, Germany
| | - Hagen B Huttner
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus-Liebig-University Giessen, 35032, Marburg, Germany
| | - Mesut Yeniguen
- Department of Neurology, Justus-Liebig University Giessen, Klinikstrasse 33, 35385, Giessen, Germany
- Heart and Brain Research Group, 35385, Giessen, Germany
- NeuroCentrum Wetzlar, Sportparkstrasse 2, 35578, Wetzlar, Germany
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Rashad S, Niizuma K, Sato-Maeda M, Fujimura M, Mansour A, Endo H, Ikawa S, Tominaga T. Early BBB breakdown and subacute inflammasome activation and pyroptosis as a result of cerebral venous thrombosis. Brain Res 2018; 1699:54-68. [PMID: 29981290 DOI: 10.1016/j.brainres.2018.06.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 06/23/2018] [Accepted: 06/24/2018] [Indexed: 02/04/2023]
Abstract
Cerebral venous thrombosis (CVT) is a rare form of cerebral stroke that causes a variety of symptoms, ranging from mild headache to severe morbidity or death in the more severe forms. The use of anti-coagulant or thrombolytic agents is the classical treatment for CVT. However, the development of new therapies for the treatment of the condition has not been the focus. In this study, we aimed to analyze the pathophysiology of CVT and to identify the pathways associated with its pathology. Moreover, mechanisms that are potential drug targets were identified. Our data showed the intense activation of immune cells, particularly the microglia, along with the increase in macrophage activity and NLRP3 inflammasome activation that is indicated by NLRP3, IL-1β, and IL-18 gene and caspase-1 upregulation and cleavage as well as pyroptotic cell death. Leukocytes were observed in the brain parenchyma, indicating a role in CVT-induced inflammation. In addition, astrocytes were activated, and they induced glial scar leading to parenchymal contraction during the subacute stage and tissue loss. MMP9 was responsible primarily for the BBB breakdown after CVT and it is mainly produced by pericytes. MMP9 activation was observed before inflammatory changes, indicating that BBB breakdown is the initial driver of the pathology of CVT. These results show an inflammation driven pathophysiology of CVT that follows MMP9-mediated BBB breakdown, and identified several targets that can be targeted by pharmaceutical agents to improve the neuroinflammation that follows CVT, such as MMP9, NLRP3, and IL-1β. Some of these pharmaceutical agents are already in clinical practice or under clinical trials indicating a good potential for translating this work into patient care.
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Affiliation(s)
- Sherif Rashad
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Neurosurgical Engineering and Translational Neuroscience, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan.
| | - Mika Sato-Maeda
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Miki Fujimura
- Department of Neurosurgery, Kohnan Hospital, Sendai, Japan
| | - Ahmed Mansour
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidenori Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shuntaro Ikawa
- Department of Project Programs, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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Wei Y, Deng X, Sheng G, Guo XB. A rabbit model of cerebral venous sinus thrombosis established by ferric chloride and thrombin injection. Neurosci Lett 2017; 662:205-212. [PMID: 29061392 DOI: 10.1016/j.neulet.2017.10.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 09/18/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Cerebral venous sinus thrombosis (CVST) is a life-threatening disease with high misdiagnosis and mortality rates due to its complex etiology and unknown pathophysiology. The present study aimed to establish an animal model suitable for assessing the pathophysiology of CVST and develop treatment methods. METHODS 40% ferric chloride (FeCl3) was administered for 5min followed by thrombin injection to induce superior sagittal sinus thrombosis (SSST). Digital subtraction angiography (DSA) was performed to ensure thrombosis and evaluate the recanalization rate 7days post-CVST. Neurological evaluation, Evans blue injection, 2,3,5-Triphenyltetrazolium chloride (TTC), and hematoxylin-eosin (H&E) staining were used to assess thrombosis and the accompanying brain parenchyma. RESULTS SSST was detected in all model rabbits, with a thrombus recanalization rate of 10%. Brain infarction, hemorrhage, cell edema, and disruption of the blood-brain barrier (BBB) were also observed. CONCLUSION The method of inducing cerebral venous sinus thrombosis by applying 40% FeCl3 and injecting thrombin is feasible and efficient. This experimental model mimics the pathogenesis and pathophysiology of actual CVST.
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Affiliation(s)
- Ying Wei
- Department of Neuro-Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Xin Deng
- Department of Neuro-Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Guan Sheng
- Department of Neuro-Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Xin-Bin Guo
- Department of Neuro-Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China.
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Boukobza M, Crassard I, Bousser MG, Chabriat H. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases. Neuroradiology 2015; 58:11-6. [PMID: 26376804 DOI: 10.1007/s00234-015-1594-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). METHODS Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. RESULTS CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. CONCLUSION This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it.
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Affiliation(s)
- Monique Boukobza
- Department of Neuroradiology and Therapeutic Angiography, Assistance publique - University Hospitals Lariboisière-St-Louis-Fernand-Widal, APHP - Paris-Diderot University, France.2, rue Ambroise Paré, 75010, Paris, France.
| | - Isabelle Crassard
- Department of Neurology, Assistance publique - University Hospitals Lariboisière-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Paris, France
| | - Marie-Germaine Bousser
- Department of Neurology, Assistance publique - University Hospitals Lariboisière-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Paris, France
| | - Hugues Chabriat
- Department of Neurology, Assistance publique - University Hospitals Lariboisière-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Paris, France.,INSERM UMR 1161 and DHU NeuroVasc, Paris, France
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Chen C, Wang Q, Gao Y, Lu Z, Cui X, Zheng T, Liu Y, Li X, He X, Zhang X, Duan C, Li T. Photothrombosis combined with thrombin injection establishes a rat model of cerebral venous sinus thrombosis. Neuroscience 2015; 306:39-49. [PMID: 26297898 DOI: 10.1016/j.neuroscience.2015.08.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 08/08/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Cerebral venous sinus thrombosis (CVST) is a rare but life-threatening disease and an animal model for in-depth study of CVST is needed. This study aimed to develop a rat model suitable for studying clinically relevant aspects of CVST and investigating its dynamic pathophysiological changes during a 7-day period. METHOD A photothrombosis method was used to create a rat sinus-vein thrombosis model. A spot size-adjustable Diode Pumped Solid State laser (DPSS) combined with thrombin injection occluded the rostral and caudal superior sagittal sinus (SSS). The model was used to evaluate pathophysiological changes at different time points over 7 days. Evans Blue dye injection was used to detect alterations in blood-brain barrier (BBB) permeability. Brain water content was also measured. Moreover, we examined changes in brain infarct volume, neurological function, as well as histology after induction of CVST. RESULT CVST in rats significantly altered BBB permeability, consistent with the development of brain edema. It was accompanied by an increase in brain infarct volume and deficits in neurological function that began on day 1, peaked on day 2, and typically improved by day 7 due to the neuroprotective effects of angiogenesis and gliocyte proliferation. CONCLUSION In this study, we describe a rat model that produces clinically relevant pathophysiology and pathology that will facilitate evaluation of therapeutic regimens for CVST. Furthermore, our results indicate a period of optimal clinical intervention for patients with CVST, which may reduce the probability of dependency and death.
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Affiliation(s)
- C Chen
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Q Wang
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
| | - Y Gao
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Z Lu
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - X Cui
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - T Zheng
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Y Liu
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - X Li
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - X He
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - X Zhang
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - C Duan
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - T Li
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
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Langheinrich AC, Yeniguen M, Ostendorf A, Marhoffer S, Dierkes C, von Gerlach S, Nedelmann M, Kampschulte M, Bachmann G, Stolz E, Gerriets T. In vitro evaluation of the sinus sagittalis superior thrombosis model in the rat using 3D micro- and nanocomputed tomography. Neuroradiology 2009; 52:815-21. [PMID: 19921163 DOI: 10.1007/s00234-009-0617-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 10/09/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Thrombosis of the cerebral veins and sinus are common causes of stroke. Animal models help us to understand the underlying pathophysiology of this condition. Therefore, the purpose of our study was to evaluate a well-established model for sinus sagittalis (SSS) thrombosis using micro- and nanocomputed tomography (CT) imaging. METHODS SSS thrombosis was performed in four rats. After contrast perfusion, brains were isolated and scanned using micro-CT at (8 microm)(3) voxel size to generate 3D images of the cerebral vasculature. For more detailed information on vascular perfusion territories, nano-CT imaging was performed to investigate the boundary layer of contrast-enhanced vessels and the occluded veins. The venous and arterial vascular volume fraction and gray scale measurements were obtained in the SSS thrombosis group and compared to controls. The significance of differences in vascular volume fraction and gray scale measurements was tested with analysis of variance. Results were complemented with histology. RESULTS Micro-CT proved to accurately visualize and differentiate vascular occlusion territories performed in the SSS thrombosis model. Moreover, 3D micro-CT provided quantitative information on arterial and venous vascular volume fraction. Micro-CT imaging enables a total 3D visualization of complications (ventricle rupture) in the SSS thrombosis model. We established gray scale measurements by which focal cerebral ischemia could be radiographically categorized (p < 0.001). CONCLUSIONS Using nano-CT, the interface of contrast-perfused and occluded veins can be visualized. Micro-CT is feasible for analysis and differentiation of perfusion territories in an animal model of focal cerebral ischemia.
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Wang J, Tan HQ, Li MH, Sun XJ, Fu CM, Zhu YQ, Zhou B, Xu HW, Wang W, Xue B. Development of a new model of transvenous thrombosis in the pig superior sagittal sinus using thrombin injection and balloon occlusion. J Neuroradiol 2009; 37:109-15. [PMID: 19665793 DOI: 10.1016/j.neurad.2009.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2009] [Revised: 06/08/2009] [Accepted: 06/11/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To establish an experimental model of superior sagittal sinus (SSS) thrombosis using a transvenous route, and thrombin and balloon occlusion, in pigs. METHODS The SSS was catheterized transvenously in six pigs. Thrombin was injected into the pigs' SSS to induce thrombosis. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) confirmed successful SSS thrombosis. MRI and MRV were also used to observe the evolution of thrombus and accompanying brain parenchymal changes before thrombus induction postoperatively on Days 1, 3, and 7. The pigs were sacrificed for histological examination at the follow-up. RESULTS SSS thrombosis was successfully achieved in all six pigs. On Day 1 postoperatively, MRV confirmed SSS thrombosis and MRI revealed brain edema in each animal. On Day 3, venous infarction was noted in two cases, one of which appeared to be hemorrhagic. On Day 7, MRV showed partial recanalization of the SSS in one pig. Brain edema was significantly relieved in four cases while, in two other cases, the extent of venous infarction was reduced. Histological examination confirmed SSS thrombosis in all animals, with recanalization in only one case. In two of the animals, bilateral parasagittal infarction was seen, including one with petechial hemorrhage. In the other four animals, bilateral parasagittal edema was observed. CONCLUSION The development of an experimental model of SSS via the transvenous route is feasible in pigs using thrombin and balloon occlusion. This model closely resembles SSS thrombosis in humans, and can be applied in the clinical study of this phenomenon as well as in clinical therapeutic applications.
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Affiliation(s)
- J Wang
- Department of Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, 200233 Shanghai, China.
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Spuentrup E, Wiethoff AJ, Parsons EC, Spangenberg P, Stracke CP. High spatial resolution magnetic resonance imaging of experimental cerebral venous thrombosis with a blood pool contrast agent. Eur J Radiol 2009; 74:445-52. [PMID: 19394183 DOI: 10.1016/j.ejrad.2009.03.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 03/27/2009] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to investigate the feasibility of clot visualization in small sinus and cortical veins with contrast enhanced MRA in a cerebral venous thrombosis animal model using a blood pool contrast agent, Gadofosveset, and high spatial resolution imaging. MATERIAL AND METHODS For induction of cerebral venous thrombosis a recently developed combined interventional and microsurgical model was used. Cerebral sinus and cortical vein thrombosis was induced in six pigs. Two further pigs died during the procedure. Standard structural, time-of-flight- and phase contrast-angiograms were followed by fast time resolved high resolution 3D MRA (4D MRA) and subsequent high spatial resolution 3D MRA in the equilibrium phase with and without addition of parallel imaging. Visualization of the clots using the different sequences was subjectively compared and contrast-to-noise ratio (CNR) was assessed. RESULTS In the remaining six animals the procedure and MR-imaging protocol including administration of Gadofosveset was successfully completed. The 3D high resolution MRA in the equilibrium phase without the addition of parallel imaging was superior to all the other applied MR measurement techniques in terms of visualization of the clots. Only applying this sequence bridging vein thromboses were also seen as a small filling defect with a high CNR of >18. CONCLUSION Only the non-accelerated high spatial resolution 3D MRA in the equilibrium in conjunction with the blood pool agent Gadofosveset allows for high-contrast visualization of very small clots in the cerebral sinus and cortical veins. STATEMENT CLINICAL IMPACT: Detection of cortical vein thrombosis is of high clinical impact. Conventional MRI sequences often fail to visualize the clot. We could demonstrate that, in contrast to conventional sequences, with high spatial resolution 3D MRA in the equilibrium in conjunction with the blood pool agent Gadofosveset very small clots in the cerebral sinus and cortical veins could be successfully visualized. We think that with the presented approach cortical vein thrombosis might also be sufficiently visualized in patients.
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Affiliation(s)
- E Spuentrup
- Department of Radiology, University Hospital, University of Cologne, Cologne, Germany.
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Stracke CP, Katoh M, Wiethoff AJ, Parsons EC, Spangenberg P, Spüntrup E. Molecular MRI of cerebral venous sinus thrombosis using a new fibrin-specific MR contrast agent. Stroke 2007; 38:1476-81. [PMID: 17379818 DOI: 10.1161/strokeaha.106.479998] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Imaging of cerebral vein thrombosis is still challenging. Currently, diagnosis is based on CT venography and MRI including MRA and conventional digital subtraction angiography. However, especially in chronic cases, each method has shown its limitations. Newer strategies for MRI are found on molecular imaging using targeted contrast agents. The aim of this study was to prove the feasibility of a novel fibrin-targeted MR contrast agent (EP-2104R; EPIX Pharmaceuticals) for selective imaging of sinus venous thrombosis in an animal model. METHODS Thrombosis of the superior sagittal sinus with human blood was induced in 6 pigs using a combined microsurgical and interventional approach. MRI was then performed before and up to 120 minutes after injection of 4 micromol/kg body weight EP-2104R. Molecular imaging was performed with a 3-dimensional high-resolution T1-weighted gradient echo sequence. Time courses of signal-to-noise ratio and contrast-to-noise ratio were analyzed. Thrombi were then surgically removed and the Gadolinium concentration was assessed. RESULTS In all cases the thrombosis could be successfully induced; the complete MR protocol could be performed in 5 animals. In these cases the thrombi showed selective enhancement after injection of the molecular contrast agent. However, a continuous contrast-to-noise ratio increase was seen up to 120 minutes after contrast administration, achieving a contrast-to-noise ratio of 14.2+/-0.7 between clot and the blood pool. CONCLUSIONS The novel fibrin-targeted molecular MR contrast EP-2104R allows selective and high-contrast imaging of cerebral sinus vein thrombosis in an animal model.
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