Verification of enhancement of the CSF space, not parenchyma, in acute stroke patients with early blood|[ndash]|brain barrier disruption

doi:doi:10.1038/sj.jcbfm.9600598

Journal of Cerebral Blood Flow & Metabolism homepage

Journal of Cerebral Blood Flow & Metabolism (2008) 28, 882–886; doi:10.1038/sj.jcbfm.9600598; published online 19 December 2007

Verification of enhancement of the CSF space, not parenchyma, in acute stroke patients with early blood–brain barrier disruption

Part of this work was presented at the 15th annual meeting of the International Society of Magnetic Resonance in Medicine, Berlin, Germany, 2007.

Erica C Henning¹, Lawrence L Latour¹ and Steven Warach¹

¹Section on Stroke Diagnostics and Therapeutics, Stroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA

Correspondence: Dr EC Henning, Section on Stroke Diagnostics and Therapeutics, Stroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10, Room B1D733, 10 Center Drive, MSC 1063, Bethesda, MD 20892, USA. E-mail: henninge@ninds.nih.gov

Received 9 July 2007; Revised 16 November 2007; Accepted 19 November 2007; Published online 19 December 2007.

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Abstract

Enhancement on post-contrast fluid-attenuated inversion recovery (FLAIR) images after acute stroke has been attributed to early blood–brain barrier disruption. Using an estimate of parenchymal volume fraction and the apparent diffusion coefficient (ADC), we investigated the relative contributions of cerebral spinal fluid (CSF) and parenchyma to enhancement seen on postcontrast FLAIR. Enhancing regions were found to have low parenchymal volume fractions and high ADC values, approaching that of pure CSF. These findings suggest that contrast enhancement on FLAIR occurs predominately in the CSF space, not parenchyma.