Abstract
The aim of this study was to use dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted magnetic resonance imaging (DWI) to measure changes in blood–brain barrier (BBB) permeability and cerebral edema over time in a rat model of asphyxial cardiac arrest (ACA). ACA was established by endotracheal tube clam**. Male rats were randomized into a sham group (n = 5) and three ACA groups (n = 18). After return of spontaneous circulation (ROSC), the rats were randomized to perform DWI and DCE-MRI exam in the 6 h, 24 h and 72 h timepoint (ROSC + 6 h, ROSC + 24 h, and ROSC + 72 h). Results shows that fifteen of 18 animals achieved successful resuscitation in the ACA groups. The average apparent diffusion coefficient(ADC) value of the whole brain in ROSC + 6 h was markedly lower than those of the sham, ROSC + 24 h, and ROSC + 72 h. The aquaporin-4(AQP4) score in ROSC + 6 h was significantly higher than those in the other groups, which were negatively correlated with the ADC values. The ratio of whole brain to masseter muscle of volume transfer constant (rKtrans), tissue interstitium-to-plasma rate constant(rKep), and fractional extra-cellular space volume(rVe) in ROSC + 6 h were all significantly higher than those in the sham, ROSC + 24 h, and ROSC + 72 h. The transforming growth factor β1(TGF-β1) and vascular endothelial growth factor A(VEGF-a) scores in ROSC + 6 h were significantly higher than those in the other groups, which were all positively correlated with rKtrans and rKep. In conclusions, brain injury is a frequent complication after CA and resuscitation. DWI and DCE-MRI can quantitatively evaluate brain injury in term of cerebral edema and BBB permeability after successful CPR.
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Data availability
Data available on request from the corresponding author.
Abbreviations
- ACA:
-
Asphyxial cardiac arrest
- ROSC:
-
Return of spontaneous circulation
- CPR:
-
Cardiopulmonary resuscitation
- BBB:
-
Blood–brain barrier
- DWI:
-
Diffusion-weighted magnetic resonance imaging
- MRS:
-
Magnetic resonance spectroscopy
- DCE-MRI:
-
Dynamic contrast-enhanced magnetic resonance imaging6
- QMR:
-
Quantitative MR
- NDS:
-
Neurology deficit score
- PC:
-
Precordial compression.
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Funding
This study was supported by the research grants from projects of Leading Talents in Pearl River Talent Plan of Guangdong Province (No. 81000-42020004), Guangzhou Science, Technology and Innovation Commission (CN) (No. 202102080580) and Natural Science Foundation of Guangdong Province (No. 2021A1515011433).
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Zhifeng Liu, Tangchun Liu and **hui Cai: Performed the experiments, data interpretation, wrote the manuscript.
Gongfa Wu, Gaungyi Wang, Yue Wang and Wanchun Tang: Performed the experiments, data interpretation.
Zhengfei Yang and Qingyu Liu: Study design, data interpretation, edited the manuscript.
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The animal experiments were approved by the Institutional Animal Care and Use Committee of the Tang Wanchun Laboratories of Emergency & Critical Care Medicine at Sun Yat-sen Memorial Hospital, Sun Yat-sen University (IACUC-SYSU -R17010).
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Liu, Z., Liu, T., Cai, J. et al. Quantitative magnetic resonance imaging assessment of brain injury after successful cardiopulmonary resuscitation in a rat model of asphyxia cardiac arrest. Brain Imaging and Behavior 16, 270–280 (2022). https://doi.org/10.1007/s11682-021-00500-0
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DOI: https://doi.org/10.1007/s11682-021-00500-0