Predicting and optimizing the territory of blood-brain barrier opening by superselective intra-arterial cerebral infusion under dynamic susceptibility contrast MRI guidance

J Cereb Blood Flow Metab. 2016 Mar;36(3):569-75. doi: 10.1177/0271678X15615875. Epub 2015 Nov 5.


Interventional neuroradiology techniques are minimally invasive and allow for superselective drug delivery to specific brain regions. The passage of most agents, however, is impaired by the blood-brain barrier (BBB). Despite its discovery over 40 years ago, hyperosmotic BBB opening (BBBO) remains highly variable, preventing its widespread implementation. Here, we report on a technique that enables the prediction and optimization of the BBBO territory. We found that the microcatheter tip position and the speed of hyperosmolar mannitol injection, both major determinants of the targeted territory, can be modulated in real-time as guided by trans-catheter perfusion MRI.

Keywords: Blood–brain barrier opening; MRI; intra-arterial; mannitol.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood-Brain Barrier / metabolism*
  • Brain / blood supply*
  • Infusions, Intra-Arterial
  • Magnetic Resonance Angiography / methods*
  • Mannitol / administration & dosage*
  • Osmolar Concentration
  • Rabbits


  • Mannitol