Imaging of Angiogenesis in White Matter Hyperintensities

Background White matter hyperintensities (WMHs) are areas of increased signal intensity on T2‐weighted magnetic resonance imaging (MRI). WMH penumbra may be a potential target for early intervention in WMHs. We explored the relationship between angiogenesis and WMH penumbra in patients with WMHs. Me...

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Main Authors: Lingling Ding, Bo Hou, Jie Zang, Tong Su, Feng Feng, Zhaohui Zhu, Bin Peng
Format: Article
Language:English
Published: Wiley 2023-11-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.122.028569
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author Lingling Ding
Bo Hou
Jie Zang
Tong Su
Feng Feng
Zhaohui Zhu
Bin Peng
author_facet Lingling Ding
Bo Hou
Jie Zang
Tong Su
Feng Feng
Zhaohui Zhu
Bin Peng
author_sort Lingling Ding
collection DOAJ
description Background White matter hyperintensities (WMHs) are areas of increased signal intensity on T2‐weighted magnetic resonance imaging (MRI). WMH penumbra may be a potential target for early intervention in WMHs. We explored the relationship between angiogenesis and WMH penumbra in patients with WMHs. Methods and Results Twenty‐one patients with confluent WMHs of Fazekas grade ≥2 were included. All the participants underwent 68Ga‐NOTA‐PRGD2 positron emission tomography/magnetic resonance imaging. WMH penumbra was analyzed with masks created for the WMH and 7 normal‐appearing white matter layers; each layer was dilated away from the WMH by 2 mm. Angiogenesis array and ELISA were used to detect the serum levels of angiogenic factors, inflammatory factors, HIF‐1 alpha, and S100B. Fourteen patients with increased 68Ga‐NOTA‐PRGD2 maximum standardized uptake (>0.17) were classified into group 2. Seven patients with maximum standardized uptake ≤0.17 were classified as group 1. WMH volume and serum levels of integrin αvβ3, vascular endothelial growth factor receptor 22, and interleukin‐1β tended to be higher in group 2 than in group 1. In group 2, 68Ga‐NOTA‐PRGD2 uptake was significantly increased at the border between the WMH and normal‐appearing white matter than in WMHs (P=0.004). The structure penumbra, defined by fractional anisotropy, was wider in group 2 (8 mm) than in group 1 (2 mm). The cerebral blood flow penumbra was 12 mm in both groups. Angiogenesis showed a correlation with reduced cerebral blood flow and microstructure integrity. Conclusions Our study provides evidence that angiogenesis occurs in the WMH penumbra. Further studies are warranted to verify the effect of angiogenesis on WMH growth.
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spelling doaj.art-ef8ddf9a050c433ab0e4f5de503f2cad2023-12-08T11:09:10ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-11-01122110.1161/JAHA.122.028569Imaging of Angiogenesis in White Matter HyperintensitiesLingling Ding0Bo Hou1Jie Zang2Tong Su3Feng Feng4Zhaohui Zhu5Bin Peng6Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing ChinaDepartment of Nuclear Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing ChinaDepartment of Nuclear Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing ChinaDepartment of Neurology Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing ChinaBackground White matter hyperintensities (WMHs) are areas of increased signal intensity on T2‐weighted magnetic resonance imaging (MRI). WMH penumbra may be a potential target for early intervention in WMHs. We explored the relationship between angiogenesis and WMH penumbra in patients with WMHs. Methods and Results Twenty‐one patients with confluent WMHs of Fazekas grade ≥2 were included. All the participants underwent 68Ga‐NOTA‐PRGD2 positron emission tomography/magnetic resonance imaging. WMH penumbra was analyzed with masks created for the WMH and 7 normal‐appearing white matter layers; each layer was dilated away from the WMH by 2 mm. Angiogenesis array and ELISA were used to detect the serum levels of angiogenic factors, inflammatory factors, HIF‐1 alpha, and S100B. Fourteen patients with increased 68Ga‐NOTA‐PRGD2 maximum standardized uptake (>0.17) were classified into group 2. Seven patients with maximum standardized uptake ≤0.17 were classified as group 1. WMH volume and serum levels of integrin αvβ3, vascular endothelial growth factor receptor 22, and interleukin‐1β tended to be higher in group 2 than in group 1. In group 2, 68Ga‐NOTA‐PRGD2 uptake was significantly increased at the border between the WMH and normal‐appearing white matter than in WMHs (P=0.004). The structure penumbra, defined by fractional anisotropy, was wider in group 2 (8 mm) than in group 1 (2 mm). The cerebral blood flow penumbra was 12 mm in both groups. Angiogenesis showed a correlation with reduced cerebral blood flow and microstructure integrity. Conclusions Our study provides evidence that angiogenesis occurs in the WMH penumbra. Further studies are warranted to verify the effect of angiogenesis on WMH growth.https://www.ahajournals.org/doi/10.1161/JAHA.122.028569angiogenesiscerebral blood flowPET/MRIwhite matter hyperintensities
spellingShingle Lingling Ding
Bo Hou
Jie Zang
Tong Su
Feng Feng
Zhaohui Zhu
Bin Peng
Imaging of Angiogenesis in White Matter Hyperintensities
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
angiogenesis
cerebral blood flow
PET/MRI
white matter hyperintensities
title Imaging of Angiogenesis in White Matter Hyperintensities
title_full Imaging of Angiogenesis in White Matter Hyperintensities
title_fullStr Imaging of Angiogenesis in White Matter Hyperintensities
title_full_unstemmed Imaging of Angiogenesis in White Matter Hyperintensities
title_short Imaging of Angiogenesis in White Matter Hyperintensities
title_sort imaging of angiogenesis in white matter hyperintensities
topic angiogenesis
cerebral blood flow
PET/MRI
white matter hyperintensities
url https://www.ahajournals.org/doi/10.1161/JAHA.122.028569
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AT fengfeng imagingofangiogenesisinwhitematterhyperintensities
AT zhaohuizhu imagingofangiogenesisinwhitematterhyperintensities
AT binpeng imagingofangiogenesisinwhitematterhyperintensities