Introduction An effective paradigm for treatment of human ICH doesn’t exist. We have established MRI biomarkers enabling understanding of pathomechanisms of recovery from animal ICH models to the human, aided by NIH funded projects.

Aim of Study Translational, non-invasive MRI biomarker development in human ICH, including iron overload, proportional erythrolysis, and white matter survival within and around the hematoma.

Methods Validation of a method of iron quantification in a phantom interrogated in animal and human magnet MRI (9.4 & 3Tesla: T1, T2*-6 echo, R2*, FLAIR, DTI). The principle was applied to animal ICH model correlating iron concentrations with them euthanized. It was then applied to 20 human ICH with MRI at 1-3 day, 7-10 day and 1 month. In addition to iron quantification we also analyzed hematoma size, surrounding edema, proportional erythrolysis plus white matter survival within and around the hematoma.

Results In ICH, the iron overload to the surrounding tissue is based on hematoma size, proportional erythrolysis within ICH, and correlates with the extent of edema. Iron overload peaks up to 10 days reducing by the end of the month in the animal and human. Some white matter tracts survive within the hematoma acting as scaffolds for macrophage mediated iron overload clearance in the animal and the human and in surrounding tissue is inversely related to iron overload.

Conclusion Our data shows initial validation and translation of multiparametric MRI as objective biomarkers of human ICH which could enable prognostication and be recovery surrogates of therapeutic interventions in future ICH trials.

Disclosure of Interest no.