A Method for Imaging the Ischemic Penumbra with MRI using IVIM (2411.00671v2)

Abstract: This work examines the hypothesis that intravoxel incoherent motion MRI (IVIM) can quantify local cerebral blood flow (qCBF), infarct volume, and define the ischemic penumbra for determination of the perfusion-diffusion mismatch (PWI/DWI) volume in a setting of acute ischemic stroke. Eight experiments were conducted in a pre-clinical middle cerebral artery occlusion (MCAO) model. IVIM and dynamic susceptibility contrast (DSC) imaging were acquired 2.5hr post-MCAO. IVIM was post-processed using software written in-house to produce parametric images of local qCBF, Water Transport Time (WTT), diffusion, and subsequently, PWI/DWI mismatch. These IVIM image parameters were compared with delay-and-dispersion-corrected local-AIF DSC perfusion image parameters including Tmax, qCBF, mean transit time (MTT), and mean diffusivity for DSC PWI/DWI mismatch. Final infarct volume was measured 4hrs post-occlusion. Early (2.5hr post-occlusion) DSC qCBF and IVIM qCBF in the diffusion negative MCA territory correlated strongly (slope=1.00, p=0.01,R2=0.69,Lins CCC=0.71), and both DSC and IVIM qCBF values negatively correlated with final infarct volume (R2=0.78,R2=0.61 respectively). The volume of hypoperfusion measured at 2.5 hours from DSC qCBF and from IVIM qCBF both predicted final infarct volume with good sensitivity and correlation (slope=2.08, R2=0.67, slope=2.50,R2=0.68 respectively). IVIM PWI/DWI ratio was correlated with infarct growth (R2=0.70) and WTT correlated with MTT (slope=0.82,R2=0.60). IVIM qCBF correlated strongly with local-AIF DSC qCBF and IVIM PWI/DWI correlated strongly with infarct growth. Both DSC and IVIM quantitative perfusion image acquired early after occlusion were able to predict final infarct volume, and IVIM simultaneous PWI/DWI ratio predicted infarct growth.