MR Quantification of Myocardial Oxygen Utilization in Chronic Myocardial Infarction without Contrast

无对比慢性心肌梗塞心肌氧利用的 MR 定量

• 批准号: 10377318
• 负责人: Keigo Kawaji
• 金额: $ 16.61万
• 依托单位: ILLINOIS INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10377318
• 关键词: Acute; Affect; American Heart Association; Anatomy; Angiography; Architecture; Biomechanics; Biomedical Engineering; Cardiac; Cardiovascular Diseases; Catheters; Cause of Death; Cessation of life; Chicago; Chronic; Clinical; Clinical Sciences; Contrast Media; Coronary; Coronary Arteriosclerosis; Coronary Artery Bypass; Data; Databases; Detection; Development; Development Plans; Diagnosis; Discipline; Dissection; Echocardiography; Engineering; Evaluation; Exhibits; Functional disorder; Gadolinium; Goals; Gold; Heart; Heart Diseases; Image; Image Analysis; Individual; Infarction; Injections; Injury; Ionizing radiation; Knowledge; Lead; MRI Scans; Magnetic Resonance; Magnetic Resonance Imaging; Measurement; Measures; Medicine; Mentors; Methods; Modality; Motion; Myocardial; Myocardial Infarction; Myocardial Ischemia; Myocardial tissue; Myocardium; Operative Surgical Procedures; Outcome; Oxygen; Patient imaging; Patients; Pharmaceutical Preparations; Physicians; Physiologic pulse; Protocols documentation; Publishing; Reference Standards; Research; Research Design; Research Personnel; Risk; Roentgen Rays; Scanning; Stents; Stroke; Techniques; Testing; Thallium Myocardial Perfusion Imaging Stress Test; Time; Tissues; Training; United States; United States National Institutes of Health; Universities; Update; Validation; Ventricular Function; Work; base; brain magnetic resonance imaging; cardiac magnetic resonance imaging; career; career development; clinically significant; cohort; design; follow-up; heart imaging; image reconstruction; imaging approach; imaging biomarker; imaging modality; new technology; non-invasive imaging; novel; patient oriented; patient oriented research; percutaneous coronary intervention; pre-clinical; response; screening; technique development; technology research and development

PROJECT SUMMARY The overall goal of this research is to develop a quantitative Magnetic Resonance Imaging (MRI) approach of oxygen utilization that provides a non-invasive and effective imaging test for the assessment of myocardial infarction. According to the most recent Heart Disease and Stroke Statistical Update (2015) published by the American Heart Association, almost 1 out of every 3 deaths in the United States (US) is caused by cardiovascular diseases that include coronary artery disease (CAD) every year. Over $40 billion is spent on cardiac stress tests each year, and nearly 1.5 million individuals are undergo percutaneous coronary intervention or coronary artery bypass surgery to treat severe CAD after nuclear stress test screening. However, the occurrence of obstructive CAD found during invasive stenting/pre-surgical coronary X-ray angiography is less than 40%. The current screening paradigm is expensive, exposes patients to ionizing radiation, and carries additional risks of intimal injury and acute vessel dissection. Cardiac Magnetic Resonance Imaging is a non-invasive imaging modality that currently is the gold standard for the quantitative assessment of ventricular function and myocardial viability evaluation. In particular, LGE can assess viable or non-viable myocardial tissue by interrogating the delayed response to gadolinium-based contrast agent administration. While this LGE assessment is robust, this reference evaluation leaves no room for further improvements via scan-time reduction, and forces any further quantification of underlying tissue pathophysiology to be obtained as separate scans that prolong each patient exam. Accordingly, the 30-plus minute LGE-CMR exam with contrast injection is the widely established, and definitive state-of-art. The scientific premise for this research is that MRI of oxygen utilization provides correlative information on the extent of viable or non-viable tissue without contrast injection. We hypothesize that a non-contrast MR quantification of oxygen utilization in less than one minute of additional scan-time to current routine cardiac MR protocol may offer a new paradigm-shifting, fast alternative evaluation of myocardial infarctions without the need for contrast injection. Hence, we aim to: 1) develop the pulse sequence and advanced image reconstruction methods to quantify myocardial oxygen utilization; 2) validate this method in the patient cohort, and 3) evaluate the proposed cardiac MRI evaluation in a single-center patient imaging setting over a 3-year span in two subject cohorts. The outcome of this work is not only the scientific findings pertaining to the feasibility of the proposed MRI method, but also the compilation of an extensive 200-patient database including all quantitative study measurements of the state-of-the-art MRI evaluations, patient data including outcomes, as well as findings from other modalities such as x-ray catheter (and echo) if these are also performed.

项目摘要 本研究的总体目标是开发一种定量磁共振成像（MRI）方法， 氧利用率，为评估心肌损伤提供了一种非侵入性和有效的成像测试。 梗塞根据最新的心脏病和中风统计更新（2015年）， 根据美国心脏协会的数据，美国每3例死亡中就有1例是由 包括冠状动脉疾病（CAD）在内的心血管疾病。超过400亿美元用于 每年有近150万人接受心脏负荷试验， 介入或冠状动脉搭桥手术治疗核负荷试验筛选后的严重CAD。 然而，在有创支架植入术/术前冠状动脉X线检查中发现的阻塞性CAD的发生率 血管造影术不到40%。目前的筛查模式是昂贵的，使患者暴露于电离 辐射，并带来内膜损伤和急性血管夹层的额外风险。心脏磁 共振成像是一种非侵入性成像方式，目前是定量诊断的金标准。 评价心室功能和心肌存活性。 特别是，LGE可以通过询问延迟反应来评估存活或非存活心肌组织， 钆基造影剂给药。虽然LGE的评估是可靠的，但这一参考 评估没有留下通过减少扫描时间进一步改进的空间，并迫使任何进一步的改进。 作为单独扫描获得的潜在组织病理生理学的量化， 考试因此，30分钟以上的LGE-CMR检查与造影剂注射是广泛建立的， 最先进的技术 本研究的科学前提是氧利用率MRI提供了与氧利用率相关的信息。 无造影剂注射时存活或非存活组织的范围。我们假设非对比MR 在当前常规心脏检查的额外扫描时间不到一分钟内定量氧利用率 MR方案可能提供一种新的范式转移，快速替代心肌梗死的评价， 需要注射造影剂。 因此，我们的目标是：1）开发脉冲序列和先进的图像重建方法，以量化 心肌氧利用率; 2）在患者队列中验证该方法，以及3）评估拟议的 在两个受试者队列中，在单中心患者成像环境中进行为期3年的心脏MRI评价。 这项工作的成果不仅是与拟议的MRI的可行性有关的科学发现， 方法，而且还汇编了一个广泛的200名患者的数据库，包括所有定量研究 最新MRI评价的测量结果、患者数据（包括结局）以及结果 从其他模态，如X射线导管（和回波），如果这些也被执行。