Phenomenon of Ultra-Early Erythrolysis in Intracranial Hemorrhage in Humans on MRI

MRI 人类颅内出血超早期红细胞溶解现象

• 批准号: 9789960
• 负责人: Neeraj Chaudhary
• 金额: $ 19.5万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9789960
• 关键词: Algorithms; Animal Model; Animals; Area; Attention; Autologous; Blood; Brain; Brain Edema; Brain Injuries; Brain hemorrhage; Cell Death; Cerebral hemisphere hemorrhage; Clinical Data; Coagulation Process; Cytolysis; Data; Deposition; Edema; Erythrocytes; Event; Ferritin; Hematoma; Hemolysis; Hemorrhage; Histology; Hour; Human; Injury; Intracranial Hemorrhages; Iron; Iron-Binding Proteins; Lead; Magnetic Resonance Imaging; Maps; Measures; Mediating; Modeling; Natural History; Neurologic Deficit; Neuronal Injury; Neurons; Outcome; Pathway interactions; Patients; Peripheral; Phase; Population; Production; Proteins; Publishing; Rattus; Resolution; Role; Secondary to; Series; Serum; Stroke; Study models; Supportive care; System; Thrombin; Time; Tissues; Toxic effect; base; brain cell; brain tissue; data modeling; experimental study; human subject; improved outcome; macrophage; neurotoxicity; novel; response

Abstract Intracerebral Hemorrhage is a subtype of hemorrhagic stroke that has devastating consequences when it occurs in humans. Broadly there are two mechanisms of neuronal damage that occurs in the event of an ICH. The early brain injury is secondary to the hematoma itself and early erythrolysis within 24 hours of the injury. Delayed brain injury is mediated by various pathways related to the scavenging of the hematoma by the macrophage system. There is reasonable animal model data that validates pathomechanisms of delayed neurotoxicity following an ICH. Ultra-early erythrolysis is a novel phenomenon that has been observed in a recent animal ICH model study by the authors. In this rat model there is good correlation of early erythrolysis with hypo or isointensity on T2* sequences within the hematoma within first 24 hours after an ICH and increased tissue iron levels in the perihematomal brain tissue on histology. There is no such correlative phenomenon that has been documented in the human population. The proposed study will attempt to confirm or refute the presence of the phenomenon of ultra-early erythrolysis and mediated neuronal injury due to increased iron levels in the periphery of the hematoma based on MRI. Various MRI parameters like volume of T2* iso/non-hypointensity within the hematoma, R2* value in the periphery of the hematoma and volume of edema on FLAIR sequence will be measured on day 1, day14 and day 30 to evaluate the presence of the phenomenon of ultra-early erythrolysis in ICH in human subjects, not only in the first 24 hrs but also up to 30 days following the hematoma.

抽象的 脑出血是出血性中风的一种亚型，发生时会造成毁灭性后果 在人类中。一般来说，脑出血时发生的神经元损伤有两种机制。早期的 脑损伤继发于血肿本身和损伤后 24 小时内的早期红细胞溶解。大脑迟缓 损伤是由与巨噬细胞系统清除血肿相关的各种途径介导的。 有合理的动物模型数据可以验证迟发性神经毒性的病理机制 ICH。超早期红细胞溶解是最近在动物 ICH 模型研究中观察到的一种新现象 作者。在该大鼠模型中，早期红细胞溶解与 T2* 低强度或等强度具有良好的相关性 ICH 后 24 小时内血肿内的序列以及组织铁水平升高 血肿周围脑组织的组织学。没有记录到这种相关现象 在人口中。拟议的研究将试图证实或反驳这种现象的存在 由于周围铁水平增加导致超早期红细胞溶解和介导的神经元损伤 基于 MRI 的血肿。各种 MRI 参数，例如 T2* 等值/非低血压体积 血肿、血肿周围的 R2* 值和 FLAIR 序列上的水肿体积为 在第1天、第14天和第30天进行测量，以评估患者是否存在超早期红细胞溶解现象。 人类受试者中的 ICH，不仅发生在血肿发生后的前 24 小时内，而且发生在血肿后长达 30 天内。