Motivation: Characterizing neurometabolic vulnerability to ischemia is essential for better stroke management but remains largely unexplored in patients. Goal(s): To map spatial neurometabolic vulnerability patterns in ischemic stroke using high-resolution 3D 1H-MRSI. Approach: We performed 3D 1H-MRSI scans using the SPICE technique (scan time: 8 minutes, resolution: 2×3×3 mm3, FOV: 240×240×72 mm3) on 105 acute ischemic stroke patients, with 21 follow-up scans. Results: Voxel-wise vulnerability index (VI) maps for N-acetylaspartate, creatine, choline, and lactate were obtained. Regional differences in neurometabolic vulnerability and dynamic changes over time were revealed. Incorporating neurometabolic VI data improved infarct prediction accuracy. Impact: Neurometabolic vulnerability maps obtained in acute stroke patients provide useful insights into cellular vulnerability patterns that could inform more effective stroke management.
Meng et al. (Tue,) studied this question.