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Updated: Apr 17, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Temporal evolution of ischemic lesions in nonhuman primates: a diffusion and perfusion MRI study
Xiaodong Zhang1, Frank Tong2, Chun-Xia Li1
1Yerkes National Primate Research Center, Emory University, Atlanta, Georgia 30329, United States of America.
Background And Purpose:
Diffusion-weighted imaging (DWI) and perfusion MRI were used to examine the spatiotemporal evolution of stroke lesions in adult macaques with ischemic occlusion.
Methods:
Permanent MCA occlusion was induced with silk sutures through an interventional approach via the femoral artery in adult rhesus monkeys (n = 8, 10-21 years old). The stroke lesions were examined with high-resolution DWI and perfusion MRI, and T2-weighted imaging (T2W) on a clinical 3T scanner at 1-6, 48, and 96 hours post occlusion and validated with H&E staining.
Results:
The stroke infarct evolved via a natural logarithmic pattern with the mean infarct growth rate = 1.38 ± 1.32 ml per logarithmic time scale (hours) (n = 7) in the hyperacute phase (1-6 hours). The mean infarct volume after 6 hours post occlusion was 3.6±2.8 ml (n = 7, by DWI) and increased to 3.9±2.9 ml (n = 5, by T2W) after 48 hours, and to 4.7±2.2ml (n = 3, by T2W) after 96 hours post occlusion. The infarct volumes predicted by the natural logarithmic function were correlated significantly with the T2W-derived lesion volumes (n = 5, r = 0.92, p = 0.01) at 48 hours post occlusion. The final infarct volumes derived from T2W were correlated significantly with those from H&E staining (r = 0.999, p < 0.0001, n = 4). In addition, the diffusion-perfusion mismatch was visible generally at 6 hours but nearly diminished at 48 hours post occlusion.
Conclusion:
The infarct evolution follows a natural logarithmic pattern in the hyperacute phase of stroke. The logarithmic pattern of evolution could last up to 48 hours after stroke onset and may be used to predict the infarct volume growth during the acute phase of ischemic stroke. The nonhuman primate model, MRI protocols, and post data processing strategy may provide an excellent platform for characterizing the evolution of acute stroke lesion in mechanistic studies and therapeutic interventions of stroke disease.
Insights
Stroke lesion growth in macaques follows a natural logarithmic pattern during the hyperacute phase. This pattern can help predict infarct volume changes in acute ischemic stroke.
Area of Science:
- Neuroscience
- Radiology
- Medical Imaging
Background:
- Stroke is a leading cause of death and disability worldwide.
- Understanding the spatiotemporal evolution of stroke lesions is crucial for developing effective treatments.
Purpose of the Study:
- To examine the evolution of ischemic stroke lesions in nonhuman primates using advanced MRI techniques.
- To characterize the spatiotemporal dynamics of infarct growth in the acute phase of stroke.
Main Methods:
- Permanent middle cerebral artery (MCA) occlusion was induced in adult rhesus monkeys.
- High-resolution diffusion-weighted imaging (DWI) and perfusion MRI were performed at multiple time points post-occlusion.
- Lesion volumes were quantified and validated with T2-weighted imaging (T2W) and H&E staining.
Main Results:
- Stroke infarcts exhibited a natural logarithmic growth pattern in the hyperacute phase (1-6 hours).
- Infarct volumes increased significantly from 6 to 96 hours post-occlusion.
- Diffusion-perfusion mismatch diminished by 48 hours, and logarithmic predictions correlated well with observed lesion volumes.
Conclusions:
- Infarct evolution follows a natural logarithmic pattern in the early stages of ischemic stroke.
- This logarithmic model can predict infarct volume growth in the acute phase.
- The nonhuman primate model and MRI protocols offer a robust platform for stroke research and therapeutic development.
