Continuous fUS–ULM Imaging Reveals Multiscale Cerebrovascular Dynamics During Ischemia–Reperfusion

Background Microcirculatory disturbances emerging during ischemia–reperfusion critically influence tissue perfusion in acute ischemic stroke. However, existing imaging approaches are limited in their ability to continuously capture brain-wide cerebrovascular dynamics across spatial scales, restricting observation of rapid vascular and microcirculatory changes during the ischemia–reperfusion process. Methods We developed a 2.10-g dual-plane wearable ultrasound imaging platform that enables stable, long-duration monitoring of cerebrovascular dynamics throughout the entire ischemia–reperfusion process in mice. Functional ultrasound imaging was used to assess vascular function and cerebral blood volume dynamics, while ultrasound localization microscopy provided micrometer-resolution mapping of the microvascular architecture. Spatiotemporal analyses were performed to characterize hemodynamic wave propagation, vascular structural deformation, and regional differences in reperfusion dynamics. Results Simultaneous assessment of cerebral blood volume and microvascular architecture revealed multiple dimensions of cerebrovascular dynamics during ischemia–reperfusion, including recurrent spreading depolarization–associated hemodynamic waves, progressive vascular deformation and heterogeneous patterns of microvascular reperfusion. Continuous ULM imaging further enabled longitudinal tracking of perfused vascular pathways, highlighting dynamic changes in the spatial organization of microvascular networks over time. Conclusions This wearable dual-plane ultrasound platform enables long-duration monitoring of brain-wide cerebrovascular dynamics while providing super-resolution characterization of the microvascular network. The approach offers a methodological framework for investigating the temporal evolution of cerebrovascular organization during acute ischemia–reperfusion.