Lze pomocí poměru hemisfér ex-vivo zobrazených mozků detekovat rekanalizaci po trombolýze u ichemické cévní mozkové příhody?

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Title in English Can the hemisphere ratio of ex-vivo imaged brains detect recanalization after thrombolysis in ischemic stroke?
Authors

SCHEER Peter HLOŽKOVÁ Jana GOLIAŠOVÁ Simona ONDRUŠ Jaroslav BISKUPIČ Jan KUCHYNKA Michaela MIKULÍK Robert

Year of publication 2024
Type Article in Proceedings
Conference 51. pracovní konference Komise experimentální kardiologie
MU Faculty or unit

Faculty of Pharmacy

Citation
Keywords hemisphere volume ratio, recanalization, ex-vivo microCT
Description In preclinical research but also in clinical studies, the evaluation of the safety and at the same time the effectiveness of thrombolytic treatment of cerebral infarction is a very problematic discipline. In general, without reperfusion, hemorrhagic transformation and brain swelling cannot occur in the ischemic area if the occlusion lasts more than 2 hours, i.e. hemorrhagic transformation in the ischemic zone and swelling of the affected hemisphere is confirmation of either recanalization or reperfusion using the collateral circulation. The aim of the work is to compare the percentage of hemispheric asymmetry on a sample of brains with and without thrombolytic treatment, with and without cerebral infarction, and with and without hemorrhagic transformation as indirect evidence of reperfusion of the ischemic focus. 44 ex-vivo brain scans of rats were included in the study. Circle of Willis Branches Occlusion (CoWBO) was induced by the application of 2 artificial fibrin clots of size 0.3x1.5 mm applied to the left internal carotid artery. Four hours after induction of CoWBO, thrombolytic treatment was performed according to enrollment. At the latest 24 hours after occlusion, the brain was taken for a microCT scan. The brain was imaged macroscopically using an operating microscope and histological processing of the brain for HE staining was performed. The occurrence of cerebral infarction (BS), the occurrence of hemorrhagic transformations (HT) and % hemispheric asymmetry (%HA) were evaluated as a potential parameter of recanalization. Of the 44 brains analyzed, 24 (55%) had detectable HT and 20 (45%) did not. Of the 20 brains without HT, 5 (25%) had no infarction and 15 (75%) had a detected infarction. In the group of all analyzed data, only 1 brain was from a rat with induced CoWBO without thrombolytic treatment, this brain had BS. The correlation coefficient between the presence of HT and %HA in the analyzed group was 0.78 (p = 0.001) and the correlation between the degree of HT and %HA was 57% (p = 0.01). In the %hemispheric asymmetry parameter, the group of brains without hemorrhage had a %HA of 2.8+-1.7 and the group with detected HT had a value of 16.9+-8.9. The maximum %HA in the non-HT group was 5.9 and the minimum in the HT group was 6.13. The difference between %HA means between HT and non-HT brains was statistically significant (p less than 0.001). Subgroup analysis without HT with and without BS showed a non-significant difference in means of 2.82+-1.4 in BS+ vs 2.3+-2.3 in BS-. Partial results suggest that the % asymmetry of the hemispheres of ex-vivo scanned brains in preclinical stroke research can be a simple potential indicator of reperfusion of the ischemic site.
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