Stroke is the second highest cause of death globally and a leading cause of disability. It has shown increasing incidence in developing countries, where 70% strokes are of ischemic origin1. Due to its widespread prevalence and limited therapeutic management options, ongoing stroke research revolves around investigation of several therapeutic interventions in preclinical and clinical settings. Animal models have been extensively used in preclinical research2,3, and three commonly used methods to model experimental stroke include craniectomy models4,5, intraluminal suture6,7, and photothrombotic (PT) stroke model8,9. Craniectomy models involve invasive clipping, ligation or electrocoagulation techniques that can cause mechanical damage to the cortex, and intraluminal suture models require a high-level of surgical expertise and may not generate reproducible ischemic lesions. Contrastingly, the PT stroke model has gained wide acceptance due to its precise special controllability, which allows targeting of any cortical region of interest in a reproducible and minimally invasive manner10.
Although the research on the pathological mechanisms of ischemic stroke has made progress11,12, clinical treatment options and drug development still remain challenging. Quick and effective restoration of cerebral blood flow can arrest pathological events and reduce functional damage13. Therefore, thrombolysis is critical in early treatment of ischemic stroke14,15, with an optimal window of 4.5 hours after ischemia16, but most patients do not catch this time window. In addition to natural and interventional revascularization, localized spontaneous vascular regeneration, or angiogenesis can occur. Angiogenesis is triggered by hypoxia as oxygen deficiency upregulates proangiogenic factors17. This results in the subsequent upregulation of hypoxia-inducible factors, followed by the expression of angiopoietin, erythropoietin, nitric oxide synthase, vascular endothelial growth factor (VEGF) and their receptors18. Angiogenesis is also believed to occur in the adult brain, but this process remains largely unexplored19,20. Hence, a rapid, high-resolution, in vivo imaging technique is a vital asset in both visually assessing blood perfusion and brain tissue damage, and longitudinal monitoring of the ischemic area to study the mechanisms of post-stroke revascularization.
Magnetic resonance imaging (MRI) and computed tomography (CT) are commonly used brain imaging modalities in clinical practice 21,22. MRI has a high sensitivity and specificity for detecting pathological changes such as cerebral vessels, lesions, and tumors, but repeated MRI scans can be outrageously expensive and time consuming. CT provides fast and high-quality images, but frequent measurements involve high levels of radiation exposure. While these non-optical imaging methods can achieve a large imaging depth, their resolution is limited to the sub-millimeter level.
Resultingly, optical imaging techniques are becoming a popular choice for brain studies due to their high spatial and temporal resolution10,23,24. Researchers have demonstrated an increasing impact on brain imaging by using photoacoustic microscopy (PAM)23, which can measure blood flow and oxygen metabolism by detecting endogenous and exogenous contrasts 25. However, PAM requires water as the coupling medium for ultrasound transmission, making the system huge and complicated. Two-photon (2P) microscopy, allows subcellular image resolution and imaging depths of several hundred micrometers into living brain tissue26, but struggles to assess large-scale blood flow in typical stroke models due to its slow three-dimensional (3D) scan speeds and limited field of view (FOV). Furthermore, 2P microscopy observations of stroke models may permit dye leakage thus impeding microvasculature imaging due to ischemic damage to the cortical tissue27. It would therefore be particularly useful for stroke studies to have intrinsic contrast blood flow signals without introducing exogenous agents into the system. Laser speckle contrast imaging (LSCI) is a label-free technique that utilizes dynamic light scattering to visualize blood flow28, providing measurements of relative flow velocity across a large FOV. However, LSCI suffers from limited spatial resolution, being limited to two-dimensional imaging and lacking depth-resolved information.
Optical coherence tomography (OCT)29 is an emerging optical imaging modality that enables three-dimensional (3D) volumetric imaging of biological tissue microstructure. Additionally, because OCT is a non-invasive, contrast agent and radiation free technique, it shows high promise across a wide range of medical and biological applications. OCT angiography (OCTA)30 is the application of OCT for measuring and visualizing 3D mapping of blood perfusion, achieved by mathematically analyzing the red blood cells’ motion-induced temporal changes of scattering signals. Compared with other optical techniques, OCTA allows rapid, high-sensitivity, contrast-free imaging with micron-scale resolution, making it a promising choice for large field of view applications like stroke monitoring10.
However, for high-resolution optical imaging, the pursuit of diffraction-limited resolution is often accompanied by a trade-off in the form of a reduced DOF, resulting in a degradation of lateral resolution beyond the optical focal plane. This constraint impedes rapid acquisition of high-resolution images of samples with irregular surfaces. Imaging such tissues usually involves laborious axial scanning at multiple planes and complicated image processing procedures. Furthermore, for time-sensitive applications like intraoperative histology or cerebral hemodynamics, rapid high-resolution imaging of irregular surfaces along a large DOF is incredibly desirable. Consequently, numerous approaches have been attempted to enable high-resolution, large DOF imaging. Multi-beam structures31 can achieve a larger DOF by simultaneously focusing on different depths of the sample, but require complex hardware and software implementations. Additionally, non-diffracting beams such as Bessel32,33 or Airy34 beams can achieve large DOF and high resolution, but the imaging quality is usually limited by the severe sidelobes and low beam efficiency. In recent years, deep learning models have been used to improve the DOF35,36, but this requires a large amount of ground truth during training, and obtaining such data may be challenging or infeasible for certain subjects.
To improve 3D resolution in an optical microscope, we developed a needle-shaped beam (NB), demonstrating its superiority in OCT anatomical imaging of both human skin and drosophila larva 37, and furthermore, successfully applied it to PAM systems 23. In this work, we developed an NB-OCTA system that, for the first time, achieved a volumetric resolution of less than 8 µm in a non-stitched volume space of 6.4 mm × 4 mm × 620 µm. Compared to normal OCTA using Gaussian beam (GB-OCTA), NB-OCTA captures the distribution of blood vessels within a 3.4-times larger depth range. We then employed NB-OCTA to perform long-term in vivo observation of cortical blood perfusion after PT stroke, and quantitatively analyzed the vessel area density (VAD) and the diameters of representative vessels in different regions over 10 days, revealing the dynamic spatial and temporal evolution of post-thrombotic blood flow perfusion. Benefiting from our NB-OCTA, we revealed that the recovery process is not only the result of spontaneous reperfusion, but also the formation of new vessels. This study provides a powerful monitoring tool for therapeutic investigations and drug screening for strokes, and deepens our understanding of the mechanisms of ischemic injury and subsequent revascularization in stroke.