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Sensors 2013, 13(6), 6981-7003; doi:10.3390/s130606981
Review

Magnetic Resonance Imaging of Ischemia Viability Thresholds and the Neurovascular Unit

1,2,3
1 Departments of Clinical Neurosciences, University of Calgary, 3330 Hospital Drive NW, Calgary, ALB T2N 4N1, Canada 2 Departments of Radiology, University of Calgary, 3330 Hospital Drive NW, Calgary, ALB T2N 4N1, Canada 3 Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, ALB T2N 4N1, Canada 
Received: 16 February 2013 / Revised: 2 May 2013 / Accepted: 6 May 2013 / Published: 27 May 2013
(This article belongs to the Special Issue Magnetic Resonance Sensors)
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Abstract

Neuroimaging has improved our understanding of the evolution of stroke at discreet time points helping to identify irreversibly damaged and potentially reversible ischemic brain. Neuroimaging has also contributed considerably to the basic premise of acute stroke therapy which is to salvage some portion of the ischemic region from evolving into infarction, and by doing so, maintaining brain function and improving outcome. The term neurovascular unit (NVU) broadens the concept of the ischemic penumbra by linking the microcirculation with neuronal-glial interactions during ischemia reperfusion. Strategies that attempt to preserve the individual components (endothelium, glia and neurons) of the NVU are unlikely to be helpful if blood flow is not fully restored to the microcirculation. Magnetic resonance imaging (MRI) is the foremost imaging technology able to bridge both basic science and the clinic via non-invasive real time high-resolution anatomical delineation of disease manifestations at the molecular and ionic level. Current MRI based technologies have focused on the mismatch between perfusion-weighted imaging (PWI) and diffusion weighted imaging (DWI) signals to estimate the tissue that could be saved if reperfusion was achieved. Future directions of MRI may focus on the discordance of recanalization and reperfusion, providing complimentary pathophysiological information to current compartmental paradigms of infarct core (DWI) and penumbra (PWI) with imaging information related to cerebral blood flow, BBB permeability, inflammation, and oedema formation in the early acute phase. In this review we outline advances in our understanding of stroke pathophysiology with imaging, transcending animal stroke models to human stroke, and describing the potential translation of MRI to image important interactions relevant to acute stroke at the interface of the neurovascular unit.
Keywords: stroke; ischemic penumbra; neurovascular unit; MRI stroke; ischemic penumbra; neurovascular unit; MRI
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Barber, P.A. Magnetic Resonance Imaging of Ischemia Viability Thresholds and the Neurovascular Unit. Sensors 2013, 13, 6981-7003.

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