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A model to predict the histopathology of human stroke using diffusion and T2-weighted magnetic resonance imaging
K M Welch1, J Windham, R A Knight
1Department of Neurology, Henry Ford Hospital and Health Sciences Center, Detroit, MI 48202, USA.
Background And Purpose:
We sought to identify MRI measures that have high probability in a short acquisition time to predict, at early time points after onset of ischemia, the eventual development of cerebral infarction in clinical patients who suffer occlusion of a cerebral artery.
Methods:
We developed an MR tissue signature model based on experimentally derived relationships of the apparent diffusion coefficient of water (ADCw) and T2 to ischemic brain tissue histopathology. In eight stroke patients we measured ADCw and T2 intensity using diffusion-weighted echo-planar imaging (DW-EPI). Tissue signature regions were defined, and theme maps of the ischemic focus at subacute time points after stroke onset were generated.
Results:
Five MR signatures were identified in human stroke foci: two that may predict either cell recovery or progression to necrosis, one that may mark the transition to cell necrosis, and two that may be markers of established cell necrosis.
Conclusions:
An MR tissue signature model of ischemic histopathology using ADCw and T2 can now be tested for its potential to predict reversible and identify irreversible cellular damage in human ischemic brain regions.
Insights
This study introduces an MRI model using apparent diffusion coefficient of water (ADCw) and T2 to predict cerebral infarction development. The model identifies cellular damage, aiding early stroke assessment.
Area of Science:
- Neuroimaging
- Biomedical Engineering
- Stroke Research
Background:
- Cerebral artery occlusion leads to ischemia and potential infarction.
- Early prediction of infarction development is crucial for clinical management.
- Current MRI methods may require long acquisition times for predictive measures.
Purpose of the Study:
- To identify rapid MRI measures for predicting cerebral infarction post-ischemia.
- To develop an MR tissue signature model correlating with histopathology.
- To assess the potential for early detection of reversible and irreversible cellular damage.
Main Methods:
- Developed an MR tissue signature model based on apparent diffusion coefficient of water (ADCw) and T2 relationships to histopathology.
- Measured ADCw and T2 in eight stroke patients using diffusion-weighted echo-planar imaging (DW-EPI).
- Generated thematic maps of ischemic foci at subacute time points.
Main Results:
- Identified five distinct MR signatures in human stroke foci.
- Two signatures may predict cell recovery or necrosis progression.
- One signature may indicate the transition to necrosis, and two suggest established necrosis.
Conclusions:
- An MR tissue signature model using ADCw and T2 shows promise for predicting ischemic histopathology.
- This model can be tested for its ability to predict reversible and irreversible cellular damage in ischemic brain regions.
- The findings support the development of rapid MRI techniques for early stroke prognostication.