An integrated vascular MR imaging suite in brain diseases

项目概要/摘要： 脑血管成像在各种脑部疾病中具有广泛的影响，包括脑血管疾病 中风、动脉狭窄、Moymoya病、小血管疾病和血管性痴呆等疾病， 而且在其它神经病症如脑肿瘤和创伤性脑损伤中也是如此。当前临床实践 脑血管成像需要多次扫描，在某些情况下，需要多次访问，以获得 全面评估大脑血管健康状况，包括灌注、血流动力学参数和流量 保护区这种限制增加了患者负担，并显著增加了护理成本。因此 本项目的目标是开发新的方法来执行集成血管（iVas）成像， 在一次扫描中提供所有相关的生理信息（<10分钟）。 所提出的iVas-MRI技术将应用伴随的O2和CO2气体吸入（但具有不同的 定时），并将同时测量脑血容量（CBV），脑血管反应性（CVR），推注 到达峰值的时间（TTP）和来自同一数据集的功能连接网络。目标1将制定三个关键 iVas-MRI技术的组成部分，特别是伴随O2和CO2气体吸入范例， 空间分辨率MRI脉冲序列和多参数数据处理算法。基于云的 还将开发一个计算平台，以使分析标准化， 法目标2将对iVas-MRI技术进行确认和多供应商评估。我们将 将iVas-MRI技术的结果与标准技术的结果进行比较，并将检查跨供应商 通过在三个MRI系统上扫描每名参与者， 通用电气、飞利浦和西门子。Aim 3将在烟雾病患者中应用该技术 并研究其在诊断和治疗监测这种情况的潜在价值。我们将 首先检查iVas-MRI在横截面设置中预测临床结果的实用性。然后通过 系列MRI，我们将检查iVas-MRI在区分两种最常见的 在烟雾病患者中进行外科手术，特别是直接与间接旁路手术。 这项工作对临床实践的长期影响是，脑血管疾病患者将 在不到10分钟的一次就诊中完成血管成像扫描（而不是多次就诊 几次扫描）。此外，对常规造影剂过敏的患者将可以获得 替代造影剂（即O2和CO2气体），以满足其血管成像需求。

Project Summary/Abstract: Cerebrovascular imaging has a broad impact in a variety of brain disorders, including cerebrovascular diseases such as stroke, arterial stenosis, Moymoya disease, small vessel diseases, and vascular dementia, but also in other neurological conditions such as brain tumor and traumatic brain injury. Current clinical practice of cerebrovascular imaging requires multiple scans and, in some cases, multiple visits in order to obtain a complete assessment of the brain’s vascular health that includes perfusion, hemodynamic parameter, and flow reserve. This limitation increases patient burden and significantly escalates the cost of care. Therefore, the goal of the present project is to develop novel methods to perform an integrated vascular (iVas) imaging that provides all relevant physiological information in a single scan (<10 minutes). The proposed iVas-MRI technique will apply concomitant O2 and CO2 gas inhalation (but with different timing) and will simultaneously measure cerebral blood volume (CBV), cerebrovascular reactivity (CVR), bolus time-to-peak (TTP), and functional connectivity networks from the same dataset. Aim 1 will develop three key components of the iVas-MRI technique, specifically concomitant O2 and CO2 gas-inhalation paradigm, high spatial-resolution MRI pulse sequence, and multi-parametric data processing algorithm. A cloud-based computation platform will also be developed for standardization of the analysis and future dissemination of the technique. Aim 2 will conduct validation and multi-vendor assessment of the iVas-MRI technique. We will compare results of the iVas-MRI technique to those of standard techniques and will examine across-vendor reproducibility of the proposed technique by scanning each participant on three MRI systems manufactured by General Electric, Philips, and Siemens, respectively. Aim 3 will apply the technique in patients with Moyamoya disease and study its potential value in both the diagnosis and treatment monitoring of this condition. We will first examine the utility of iVas-MRI in predicting clinical outcomes in a cross-sectional setting. Then, through serial MRIs, we will examine the utility of iVas-MRI in differentiating treatment benefits of two most commonly performed surgical procedures in Moyamoya patients, specifically direct versus indirect bypass surgery. The long-term impact of this work on clinical practice is that patients with cerebrovascular diseases will have their vascular imaging scan done in just one visit of less than 10 minutes (as opposed to multiple visits and several scans). Additionally, patients who are allergic to conventional contrast agent will have access to an alternative contrast agent (i.e. O2 and CO2 gases) for their vascular imaging needs.