NETs and MRI changes after ICH

Because NETs are a pharmacologically targetable neutrophil injury mechanism, this proposal will lay the foundation for future studies testing treatments directed against NETs in ICH-patients. The proposal will also demonstrate the feasibility of a novel MRI pulse sequence in ICH that will make PHE measurements a usable study endpoint in future treatment trials. The primary outcome variables are perihemorrhagic edema volume and new ischemic lesions on brain MRI, obtained on day 5 of hospitalization. The two primary outcome variables correspond to the two specific aims:

Aim 1: To identify the association between NETs and PHE volume in patients with ICH. Hypothesis: A greater blood NET level reduction between admission and day 5 is associated with larger PHE volume.

Aim 2: To determine the association between NETs and acute ischemic lesions after ICH. Hypothesis: A greater reduction in blood NET levels on day 5 is associated with acute cerebral ischemic lesions after ICH. Secondary Aim 1: will aim to establish the non-inferiority of the MRI 3D CAIPI-T2 sequence to measure ICH and PHE volumes. Volumetric measurements on the MRI 3D CAIPI-T2 images will be compared to same-day conventional SWI (hemorrhage) and 3D FLAIR (edema) images, and with CT within 24 hours from MRI imaging. Inter-rater and intra-rater variability for each modality will be calculated.

Secondary Aim 2: will test the association between the blood neutrophil-lymphocyte ratio (NLR) within 24 hours of admission and PHE on day-5 MRI.5 PHE in this secondary aim will be defined using the edema extension distance (EED), a measure of PHE independent of ICH volume.

Secondary Aim 3: will test associations between delta NETs (admission NET levels subtracted from day-5 levels) and long-term outcome at 90 days, measured by standardized telephone interviews using the modified Rankin scale (mRS).

You may be eligible for this study if you meet the following criteria:

• Conditions:
  Medical Research
• Age: - 99 Years
• Gender: All