BACKGROUND AND PURPOSE: The hyperintense acute reperfusion marker (HARM) on fluid-attenuated inversion recovery MRI is believed to be caused by gadolinium-based contrast agents crossing a disrupted blood-brain barrier. However, this hypothesis has never been directly verified in humans. METHODS: In this study, we analyzed cerebrospinal fluid samples of patients with HARM on imaging regarding the presence and concentration of gadolinium-based contrast agents. RESULTS: Gadobutrol was found in concentrations of approximately 50 μmol/L. Using phantom MRI experiments, we demonstrate that the detected concentrations are consistent with the observed HARM imaging pattern. CONCLUSIONS: Our study yields first direct evidence in humans that the imaging phenomenon HARM is indeed caused by leakage of gadolinium-based contrast agents into the cerebrospinal fluid.
BACKGROUND AND PURPOSE: The hyperintense acute reperfusion marker (HARM) on fluid-attenuated inversion recovery MRI is believed to be caused by gadolinium-based contrast agents crossing a disrupted blood-brain barrier. However, this hypothesis has never been directly verified in humans. METHODS: In this study, we analyzed cerebrospinal fluid samples of patients with HARM on imaging regarding the presence and concentration of gadolinium-based contrast agents. RESULTS:Gadobutrol was found in concentrations of approximately 50 μmol/L. Using phantom MRI experiments, we demonstrate that the detected concentrations are consistent with the observed HARM imaging pattern. CONCLUSIONS: Our study yields first direct evidence in humans that the imaging phenomenon HARM is indeed caused by leakage of gadolinium-based contrast agents into the cerebrospinal fluid.
Authors: W M Freeze; D N Ter Weele; W M Palm; R W van Hooren; E I Hoff; J F A Jansen; H I L Jacobs; F R Verhey; W H Backes Journal: AJNR Am J Neuroradiol Date: 2019-08-08 Impact factor: 3.825
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Authors: J G Merino; L L Latour; A Tso; K Y Lee; D W Kang; L A Davis; R M Lazar; K A Horvath; P J Corso; S Warach Journal: AJNR Am J Neuroradiol Date: 2012-08-23 Impact factor: 3.825