Predicting the Onset of Ischemic Stroke with Fast High-Resolution 3D MR Spectroscopic Imaging

Neurometabolite concentrations provide a direct index of infarct progression in stroke, but their relationship with stroke onset time remains unclear. Using a fast high-resolution 3D MRSI technique, this study assessed the temporal dynamics of N-acetylaspartate (NAA), creatine, choline, and lactate and estimated their value in predicting early (<6 hours) vs late (6–24 hours) hyperacute ischemic stroke groups. We found that lesional NAA and creatine was reduced from acute to subacute stroke patients and NAA level was inversely related to onset time in hyperacute patients. The changes in neurometabolite levels provided good discrimination between patients for early & late hyperacute time windows.