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. 2012 Jan;43(1):259-61.
doi: 10.1161/STROKEAHA.111.632356. Epub 2011 Oct 6.

The hyperintense acute reperfusion marker on fluid-attenuated inversion recovery magnetic resonance imaging is caused by gadolinium in the cerebrospinal fluid

Martin Köhrmann  1 , Tobias Struffert, Thomas Frenzel, Stefan Schwab, Arnd Doerfler
Affiliations

The hyperintense acute reperfusion marker on fluid-attenuated inversion recovery magnetic resonance imaging is caused by gadolinium in the cerebrospinal fluid

Martin Köhrmann et al. Stroke. 2012 Jan.

Abstract

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.

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