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Dynamic Contrast-Enhanced MRI Evaluation of Cerebral Cavernous Malformations

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Abstract

The aim of this study is to quantitatively evaluate the behavior of CNS cavernous malformations (CCMs) using a dynamic contrast-enhanced MRI (DCEMRI) technique sensitive for slow transfer rates of gadolinium. The prospective study was approved by the institutional review board and was HIPPA compliant. Written informed consent was obtained from 14 subjects with familial CCMs (4 men and 10 women, ages 22–76 years, mean 48.1 years). Following routine anatomic MRI of the brain, DCEMRI was performed for six slices, using T1 mapping with partial inversion recovery (TAPIR) to calculate T1 values, following administration of 0.025 mmol/kg gadolinium DTPA. The transfer rate (Ki) was calculated using the Patlak model, and Ki within CCMs was compared to normal-appearing white matter as well as to 17 normal control subjects previously studied. All subjects had typical MRI appearance of CCMs. Thirty-nine CCMs were studied using DCEMRI. Ki was low or normal in 12 lesions and elevated from 1.4 to 12 times higher than background in the remaining 27 lesions. Ki ranged from 2.1E−6 to 9.63E−4 min−1, mean 3.55E−4. Normal-appearing white matter in the CCM patients had a mean Ki of 1.57E−4, not statistically different from mean WM Ki of 1.47E−4 in controls. TAPIR-based DCEMRI technique permits quantifiable assessment of CCMs in vivo and reveals considerable differences not seen with conventional MRI. Potential applications include correlation with biologic behavior such as lesion growth or hemorrage, and measurement of drug effects.

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Acknowledgments

This project was supported in part by NIH grant U54 NS065705 as well the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health through Grant Number UL1 TR000041. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This project was supported in part by the Dedicated Health Research Funds of the University of New Mexico School Of Medicine.

Conflict of Interest

Blaine L. Hart, MD and Saeid Taheri, Ph.D. declares that they have no conflict of interest. Leslie A. Morrison, MD declares that she has received travel/accommodations meeting expenses from the Association of American Medical Colleges, American Association Neurology, and the CDC. Gary Rosenberg, MD declares that he has received consultancy fees from Novartis Pharmaceuticals.

Compliance with Ethics Requirements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 [5]. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Radiology, University of New Mexico, MSC10 5530, 1, Albuquerque, NM, 87131-0001, USA

    Blaine L. Hart

  2. Department of Radiology, Medical University of South Carolina, Bioengineering Bldg- 68 President St., MSC 323, RM 206, Charleston, SC, 29425, USA

    Saeid Taheri

  3. Department of Neurology, University of New Mexico, MSC10 5620, 1, Albuquerque, NM, 87131-0001, USA

    Gary A. Rosenberg & Leslie A. Morrison

Authors
  1. Blaine L. Hart
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  2. Saeid Taheri
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  3. Gary A. Rosenberg
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  4. Leslie A. Morrison
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Correspondence to Blaine L. Hart.

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Hart, B.L., Taheri, S., Rosenberg, G.A. et al. Dynamic Contrast-Enhanced MRI Evaluation of Cerebral Cavernous Malformations. Transl. Stroke Res. 4, 500–506 (2013). https://doi.org/10.1007/s12975-013-0285-y

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  • DOI: https://doi.org/10.1007/s12975-013-0285-y

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