Document Type

Article

Publication Date

1-24-2025

Comments

This article is the author's final published version in NeuroImage: Clinical, Volume 45, January 2025, Article number 103742.

The published version is available at https://doi.org/10.1016/j.nicl.2025.103742.

Copyright © 2025 The Authors

Abstract

PURPOSE: This study aims to assess whether water exchange rate (kw), a surrogate for blood-brain barrier (BBB) permeability, is associated with functional outcomes in patients with acute ischemic stroke (AIS).

METHODS: We studied 22 AIS patients enrolled from 1/2022 to 4/2024 who underwent multi-modal non-contrast imaging on a 3.0-Tesla scanner, including DP-pCASL, DTI, NODDI and MAP imaging. For each parametric map, the intensity and standard deviation (SD) were calculated for the infarcted region. The diffusion maps included were b0, Fractional Anisotropy (FA), Mean Diffusivity (MD), Intra-cellular Volume Fraction (ICVF), Free Water Fraction (FWF), and Orientation Dispersion Index (ODI), q-Space Mean Square Displacement (QMSD), Return-to-Axis Probability (RTAP), Return-to-Plane Probability (RTPP), Return-to-Origin Probability (RTOP), Propagator Anisotropy (PA), and non-Gaussianity (NG). The perfusion-based maps were cerebral blood flow (CBF), arterial transit time (ATT), and kw. The outcome variable was modified Rankin Scale (mRS). rebral blood flow (CBF), arterial transit time (ATT), and kw. The outcome variable was modified Rankin Scale (mRS).

RESULTS: Twenty-two patients were included. The average age was 69.5 ± 13.5, the mean NIHSS of 12.4 ± 7.7, and the median infarct of 25.7 (8.4-98.8) ml. Multivariable linear regression identified lower kw (β = -0.029, p = 0.041), longer time to MRI (β = 0.012, p = 0.013) and larger stroke volume (β = 0.014, p = 0.006) as predictive of higher mRS. Higher CBF (β = 0.660, p = 0.003) and RTAP (β = 1.528, p = 0.010), and lower SD RTAP (β = -0.709, p = 0.016), RTPP (β = -2.132, p = 0.006), and NG (β = -1.036, p = 0.011) were identified as most predictive of kw through multivariable linear regression analysis.

CONCLUSIONS: Lower kw is predictive of higher mRS in patients with AIS. Increasing CBF and RTAP and lower SD RTAP, RTPP, and NG were correlated with higher kw.

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

39864167

Language

English

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