7T Neurosurgical Mapping Protocol for Endoscopic Resection of Skull Base Tumors

项目摘要 尽管在大量新冠肺炎患者中观察到神经症状，但一项前瞻性研究 以先进的多模式神经成像方法扫描康复的新冠肺炎患者尚未 被执行。关于SARS-CoV-2病毒对中枢神经系统的持续影响，还有很多需要了解的 神经系统，而高分辨率磁共振成像(MRI)是理想的无创性工具 这些影响以及感染机制。在这项工作中，我们将利用高分辨率和增强 多模式7特斯拉(7T)成像提供的对比，以研究结构，血管，功能和 脑内的结缔组织改变与新冠肺炎的病理生理相关。特别是，我们将揭示， 在史无前例的细节中，由SARS-CoV-2感染引起的大脑异常以及 阐明病毒通过脑干感染导致呼吸动力丧失的可能联系。影像表现 将与临床神经症状和神经心理指标相关联。三个患者亚组 将为我们的前瞻性研究招募：无神经症状的非癌症患者 呼吸机，有神经症状的癌症患者不需要呼吸机，以及有呼吸机的患者 严重的呼吸窘迫和需要的通风。还将对临床脑进行回顾性研究。 西奈山卫生系统对一组有神经系统症状的新冠肺炎患者进行核磁共振扫描， 这一分析的结果将有助于7T研究的患者选择和对坚持的额外分析 与短暂的神经影响相比。我们的研究属于R01在7T上的应用范围 内窥镜下切除颅底肿瘤的神经外科标测方案 多模式7T成像技术显示大脑的详细解剖结构并表征疾病的影响 在这两项研究中。我们只是将队列扩大到包括新冠肺炎康复患者，并进一步优化 脑干成像，这将适用于这两项研究。我们的研究与通知的目标一致 国家档案局宣布在新冠肺炎上提供行政补充的特殊利益 不同癌症患者人群对SARS-CoV-2感染或 中枢神经系统新冠肺炎病。

Project Summary Although neurological symptoms are being observed in a high number of COVID-19 patients, a prospective study aimed at scanning recovered COVID-19 patients with advanced multi-modal neuroimaging methods has yet to be performed. There is much to be learned about the persisting effects of the SARS-CoV-2 virus on the central nervous system, and high-resolution magnetic resonance imaging (MRI) is the ideal non-invasive tool to reveal these effects as well as mechanisms of infection. In this work, we will leverage the high resolution and enhanced contrasts offered by multi-modal 7 Tesla (7T) imaging to study the structural, vascular, functional, and connectomic changes in the brain related to the pathophysiology of COVID-19. In particular, we will reveal, in unprecedented detail, brain abnormalities resulting from the SARS-CoV-2 infection as well as shine a brighter light on possible links to loss of respiratory drive due to viral infection through the brain stem. Imaging findings will be correlated to clinical neurological symptoms and neuropsychological measures. Three patient subgroups will be recruited for our prospective study: non-cancer patients with neurological symptoms who did not require a ventilator, cancer patients with neurological symptoms who did not require a ventilator, and patients who had severe respiratory distress and required ventilation. A retrospective study will also be performed on clinical brain MRI scans for a group of COVID-19 patients with neurological symptoms, seen at Mount Sinai Health System, and outcomes of this analysis will aid in patient selection for the 7T study and additional analysis of persisting versus transient neurological effects. Our study falls within the scope of our R01 application on “7T Neurosurgical Mapping Protocol for Endoscopic Resection of Skull Base Tumors” as we are applying similar multimodal 7T imaging techniques to reveal detailed anatomy in the brain and to characterize effects of disease in both studies. We will simply extend the cohort to include COVID-19 recovered patients and further optimize imaging in the brain stem which will be applicable to both studies. Our study aligns with the goals of the Notice of Special Interest announced by the NCI for administrative supplements on COVID-19 as it addresses potential for differential responses among diverse cancer patient populations to SARS-CoV-2 infection or COVID-19 disease in central nervous system.