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.

摘要 脑出血是出血性中风的一种亚型，当它发生时， 在人类身上。广泛地说，在ICH事件中发生的神经元损伤有两种机制。早期 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。迟发性脑 损伤由与巨噬细胞系统清除血肿相关的各种途径介导。 有合理的动物模型数据验证了在使用后迟发性神经毒性的病理机制。 ICH。超早期红细胞溶解是在最近的动物ICH模型研究中观察到的一种新现象 由作者。在该大鼠模型中，早期红细胞溶解与T2* 上的低或等强度具有良好的相关性。 脑出血后24小时内血肿内的组织铁水平增加， 血肿周围脑组织的组织学变化。没有这样的相关现象已被记录在案 在人类中。拟议中的研究将试图证实或反驳这种现象的存在 超早期红细胞溶解和介导的神经元损伤，由于铁水平的增加，在周围的 MRI显示血肿。各种MRI参数，如T2* 等/非低信号的体积， 血肿、血肿周围的R2* 值和FLAIR序列上的水肿体积将被 在第1天、第14天和第30天测量，以评价在第1天、第14天和第30天中超早期红细胞溶解现象的存在。 人类受试者的ICH，不仅在血肿后的前24小时内，而且长达30天。