Predicting the Onset of Ischemic Stroke With Fast High‐Resolution 3D MR Spectroscopic Imaging

作者：Zengping Lin, Ziyu Meng, Tianyao Wang, Rong Guo, Yibo Zhao, Yudu Li, Yudu Li, Bin Bo, Yue Guan, Jun Liu, Hong Zhou, Xin Yu, David J. Lin, Zhi‐Pei Liang, Parashkev Nachev, Yao Li, Yao Li · 发表于：Journal of Magnetic Resonance Imaging · 年份：2023 · DOI：10.1002/jmri.28596 · 被引用次数：10 · 研究领域：Advanced MRI Techniques and Applications、Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases

BACKGROUND: Neurometabolite concentrations provide a direct index of infarction progression in stroke. However, their relationship with stroke onset time remains unclear. PURPOSE: To assess the temporal dynamics of N-acetylaspartate (NAA), creatine, choline, and lactate and estimate their value in predicting early (<6 hours) vs. late (6-24 hours) hyperacute stroke groups. STUDY TYPE: Cross-sectional cohort. POPULATION: A total of 73 ischemic stroke patients scanned at 1.8-302.5 hours after symptom onset, including 25 patients with follow-up scans. FIELD STRENGTH/SEQUENCE: A 3 T/magnetization-prepared rapid acquisition gradient echo sequence for anatomical imaging, diffusion-weighted imaging and fluid-attenuated inversion recovery imaging for lesion delineation, and 3D MR spectroscopic imaging (MRSI) for neurometabolic mapping. ASSESSMENT: Patients were divided into hyperacute (0-24 hours), acute (24 hours to 1 week), and subacute (1-2 weeks) groups, and into early (<6 hours) and late (6-24 hours) hyperacute groups. Bayesian logistic regression was used to compare classification performance between early and late hyperacute groups by using different combinations of neurometabolites as inputs. STATISTICAL TESTS: Linear mixed effects modeling was applied for group-wise comparisons between NAA, creatine, choline, and lactate. Pearson's correlation analysis was used for neurometabolites vs. time. P < 0.05 was considered statistically significant. RESULTS: Lesional NAA and creatine...