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Computational and Mathematical Methods in Medicine
Volume 2013 (2013), Article ID 283593, 13 pages
Research Article

Spatiotemporal Dynamic Simulation of Acute Perfusion/Diffusion Ischemic Stroke Lesions Evolution: A Pilot Study Derived from Longitudinal MR Patient Data

1Division of Neuroimaging Sciences, Brain Research Imaging Centre (BRIC), Edinburgh University, UK
2CMAP, Ecole Polytechnique, route de Saclay, 91128 Palaiseau, France
3INRIA, ICM Pitié-Salpétrière Hospital, Paris, France

Received 21 December 2012; Revised 22 May 2013; Accepted 22 May 2013

Academic Editor: Edelmira Valero

Copyright © 2013 Islem Rekik et al. 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.


The spatiotemporal evolution of stroke lesions, from acute injury to final tissue damage, is complex. Diffusion-weighted (DWI) and perfusion-weighted (PWI) imaging is commonly used to detect early ischemic changes and attempts to distinguish between permanently damaged and salvageable tissues. To date, 2D and 3D measures of diffusion/perfusion regions at individual timepoints have been widely used but may underestimate the true lesion spatio-temporal dynamics. Currently there is no spatio-temporal 4D dynamic model that simulates the continuous evolution of ischemic stroke from MR images. We determined whether a 4D current-based diffeomorphic model, developed in the field of statistical modeling for measuring the variability of anatomical surfaces, could estimate patient-specific spatio-temporal continuous evolution for MR PWI (measured as mean transit time, (MTT)) and DWI lesions. In our representative pilot sample, the model fitted the data well. Our dynamic analysis of lesion evolution showed different patterns; for example, some DWI/PWI dynamic changes corresponded with DWI lesion expansion into PWI lesions, but other patterns were much more complex and diverse. There was wide variation in the time when the final tissue damage was reached after stroke for DWI and MTT.