Dan Zhu, Tianle Wang, Yingnan Bai, Xiaoxia Zhang, Zhiyu Li, Ailan Cheng, Yuehua Li, Qing Lu
{"title":"对比增强黑血MRI上的周围静脉增强皮质静脉：缺血性卒中血脑屏障破坏的新标志物。","authors":"Dan Zhu, Tianle Wang, Yingnan Bai, Xiaoxia Zhang, Zhiyu Li, Ailan Cheng, Yuehua Li, Qing Lu","doi":"10.1007/s00234-025-03658-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess the feasibility of using perivenous-enhanced cortical veins (PECVs) visualized on contrast-enhanced black-blood MRI (CEBBI) for detecting and classifying blood-brain barrier disruption (BBBD) in patients with ischemic stroke.</p><p><strong>Materials & methods: </strong>This retrospective study included 168 hospitalized patients with acute, subacute, and chronic ischemic stroke who underwent pre- and post-CEBBI imaging. BBBD was classified into three groups based on the enhancement ratio (ER) of normal-appearing white matter (NAWM) before and after contrast administration, as well as leptomeningeal and parenchymal enhancement patterns on CEBBI: no BBBD (NoBBBD), subtle BBBD (SuBBBD), and significant BBBD (SiBBBD). The number of PECVs was recorded bilaterally from the CEBBI source images. Univariate and multivariate linear regression analyses were performed to identify factors associated with BBBD.</p><p><strong>Results: </strong>Increased BBBD was significantly associated with a higher number of PECVs in both the ipsilateral and contralateral hemispheres of the infarct (all p < 0.01). Patients with SuBBBD had significantly more PECVs than those with NoBBBD (median: 14 vs. 3, p < 0.01), and the SiBBBD group had significantly more PECVs than the SuBBBD group (median: 18 vs. 14, p < 0.01). In the ipsilateral hemisphere, a median PECV count of 4.5 distinguished NoBBBD from SuBBBD with 83.3% sensitivity and 83.1% specificity. Similarly, a median count of 8.5 PECVs discriminated SuBBBD from SiBBBD with 78.5% sensitivity and 85.0% specificity.</p><p><strong>Conclusions: </strong>Our findings demonstrated that PECVs are more numerous in the SiBBBD group compared to SuBBBD and NoBBBD groups. The number of PECVs detected on high-resolution post-CEBBI provides a reliable, semi-quantitative method for identifying and classifying BBBD in patients with ischemic stroke. This method offers a direct assessment of BBB integrity and could improve clinical evaluation of stroke-related BBB disruption.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2295-2307"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perivenous-enhanced cortical veins on contrast-enhanced black-blood MRI: a novel marker for blood-brain barrier disruption in ischemic stroke.\",\"authors\":\"Dan Zhu, Tianle Wang, Yingnan Bai, Xiaoxia Zhang, Zhiyu Li, Ailan Cheng, Yuehua Li, Qing Lu\",\"doi\":\"10.1007/s00234-025-03658-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess the feasibility of using perivenous-enhanced cortical veins (PECVs) visualized on contrast-enhanced black-blood MRI (CEBBI) for detecting and classifying blood-brain barrier disruption (BBBD) in patients with ischemic stroke.</p><p><strong>Materials & methods: </strong>This retrospective study included 168 hospitalized patients with acute, subacute, and chronic ischemic stroke who underwent pre- and post-CEBBI imaging. BBBD was classified into three groups based on the enhancement ratio (ER) of normal-appearing white matter (NAWM) before and after contrast administration, as well as leptomeningeal and parenchymal enhancement patterns on CEBBI: no BBBD (NoBBBD), subtle BBBD (SuBBBD), and significant BBBD (SiBBBD). The number of PECVs was recorded bilaterally from the CEBBI source images. Univariate and multivariate linear regression analyses were performed to identify factors associated with BBBD.</p><p><strong>Results: </strong>Increased BBBD was significantly associated with a higher number of PECVs in both the ipsilateral and contralateral hemispheres of the infarct (all p < 0.01). Patients with SuBBBD had significantly more PECVs than those with NoBBBD (median: 14 vs. 3, p < 0.01), and the SiBBBD group had significantly more PECVs than the SuBBBD group (median: 18 vs. 14, p < 0.01). In the ipsilateral hemisphere, a median PECV count of 4.5 distinguished NoBBBD from SuBBBD with 83.3% sensitivity and 83.1% specificity. Similarly, a median count of 8.5 PECVs discriminated SuBBBD from SiBBBD with 78.5% sensitivity and 85.0% specificity.</p><p><strong>Conclusions: </strong>Our findings demonstrated that PECVs are more numerous in the SiBBBD group compared to SuBBBD and NoBBBD groups. The number of PECVs detected on high-resolution post-CEBBI provides a reliable, semi-quantitative method for identifying and classifying BBBD in patients with ischemic stroke. This method offers a direct assessment of BBB integrity and could improve clinical evaluation of stroke-related BBB disruption.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"2295-2307\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-025-03658-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03658-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Perivenous-enhanced cortical veins on contrast-enhanced black-blood MRI: a novel marker for blood-brain barrier disruption in ischemic stroke.
Purpose: To assess the feasibility of using perivenous-enhanced cortical veins (PECVs) visualized on contrast-enhanced black-blood MRI (CEBBI) for detecting and classifying blood-brain barrier disruption (BBBD) in patients with ischemic stroke.
Materials & methods: This retrospective study included 168 hospitalized patients with acute, subacute, and chronic ischemic stroke who underwent pre- and post-CEBBI imaging. BBBD was classified into three groups based on the enhancement ratio (ER) of normal-appearing white matter (NAWM) before and after contrast administration, as well as leptomeningeal and parenchymal enhancement patterns on CEBBI: no BBBD (NoBBBD), subtle BBBD (SuBBBD), and significant BBBD (SiBBBD). The number of PECVs was recorded bilaterally from the CEBBI source images. Univariate and multivariate linear regression analyses were performed to identify factors associated with BBBD.
Results: Increased BBBD was significantly associated with a higher number of PECVs in both the ipsilateral and contralateral hemispheres of the infarct (all p < 0.01). Patients with SuBBBD had significantly more PECVs than those with NoBBBD (median: 14 vs. 3, p < 0.01), and the SiBBBD group had significantly more PECVs than the SuBBBD group (median: 18 vs. 14, p < 0.01). In the ipsilateral hemisphere, a median PECV count of 4.5 distinguished NoBBBD from SuBBBD with 83.3% sensitivity and 83.1% specificity. Similarly, a median count of 8.5 PECVs discriminated SuBBBD from SiBBBD with 78.5% sensitivity and 85.0% specificity.
Conclusions: Our findings demonstrated that PECVs are more numerous in the SiBBBD group compared to SuBBBD and NoBBBD groups. The number of PECVs detected on high-resolution post-CEBBI provides a reliable, semi-quantitative method for identifying and classifying BBBD in patients with ischemic stroke. This method offers a direct assessment of BBB integrity and could improve clinical evaluation of stroke-related BBB disruption.
期刊介绍：
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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