Expanding on a new paradigm for MRI in pediatric congenital heart disease

拓展小儿先天性心脏病 MRI 的新范例

• 批准号: 10469364
• 负责人: Anthony G Christodoulou
• 金额: $ 68.76万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10469364
• 关键词: 3D Print; 4D MRI; Achievement; Adopted; Adult; Affect; Anatomy; Anesthesia procedures; Angiography; Bayesian Modeling; Biological; Birth; Blood Vessels; Blood flow; Breathing; Cardiac; Cardiovascular system; Catheterization; Child; Childhood; Clinical; Collaborations; Common Ventricle; Complement; Complex; Computer Models; Congenital Abnormality; Contrast Media; Data; Data Pooling; Data Set; Defect; Development; Diagnostic; Diagnostic Imaging; Echocardiography; Elements; Engineering; Evaluation; Experimental Models; Feedback; Financial compensation; Funding; Gadolinium; General Anesthesia; Goals; Heart; Image; Imaging Techniques; Imaging technology; In Vitro; Infrastructure; Institution; Intratracheal Intubation; Intubation; Ionizing radiation; Left; Liquid substance; Live Birth; Logistics; Longterm Follow-up; Magnetic Resonance Imaging; Mechanical ventilation; Methods; Modeling; Motion; Natural History; Operative Surgical Procedures; Outcome; Patient Care; Patient-Focused Outcomes; Patients; Pediatric Hospitals; Performance; Physicians; Physiologic pulse; Physiology; Population; Positioning Attribute; Public Health; Recording of previous events; Registries; Repair Complex; Resolution; Risk; Safety; Scanning; Sedation procedure; Shapes; Standardization; Structure-Activity Relationship; Surgeon; Surgical Management; Techniques; Time; Tissues; Validation; Ventricular; Work; base; cardiac magnetic resonance imaging; clinical translation; computer framework; congenital heart disorder; deep neural network; diagnostic value; experience; ferumoxytol; hemodynamics; image reconstruction; imaging modality; improved; in vivo; indexing; mortality; multi-scale modeling; next generation; novel; off-label use; outcome prediction; palliation; prevent; prospective; reconstruction; repaired; respiratory; standard of care; success; surgery outcome; technique development; time use; tool; virtual surgery

Project Summary Congenital heart disease (CHD) is the most common defect affecting approximately 1% of live births. Initially developed and optimized for adults, cardiac magnetic resonance imaging (CMR) is increasingly used in pediatric CHD patients to complement echocardiography and invasive angiography for anatomical and functional evaluation of the heart and blood vessels. For children, the non-invasiveness, unrestricted field of view, and absence of ionizing radiation make MRI an attractive imaging modality because many will need sequential imaging and long-term follow-up evaluations. However, current CMR for very young children requires general anesthesia and invasive intubation for acquisition of images that are of acceptable diagnostic quality. In the past 5 years, we pioneered ferumoxytol-enhanced CMR techniques that provide unprecedented image quality and diagnostic value; this technique has changed how CMR for pediatric CHD is clinically performed at our center. Our diagnostic application of ferumoxytol obviates any concerns about gadolinium accumulation in biologic tissues, In this renewal R01, we aim to develop next-generation CMR that can be performed without invasive intubation, and potentially with reduced anesthesia/sedation exposure. We further propose to build upon our improved CMR framework to develop advanced anatomical and hemodynamic modeling techniques for complex CHD. Together, these tools provide a CMR image-based strategy to help inform the patient's surgical plan and to ultimately predict surgical outcome. We will expand our multi-center collaborations to pool data and enable larger scale studies. Completion of the project will result in clinical deployment of new MRI pulse sequences, image acquisition and reconstruction strategies, and experimental and computational modeling methods.

项目摘要 先天性心脏病（CHD）是影响活产1％的最常见缺陷。最初 心脏磁共振成像（CMR）为成人开发和优化，越来越多地用于 小儿冠心病患者以超声心动图和侵入性血管造影的补充，以进行解剖和 心脏和血管的功能评估。对于儿童，无创，无限制的领域 视图和缺乏电离辐射使MRI成为有吸引力的成像方式，因为许多人都需要 顺序成像和长期随访评估。但是，目前针对非常小的孩子的CMR 需要一般麻醉和侵入性插管才能获取可接受的诊断图像 质量。在过去的5年中，我们开创了富含铁氧酚增强的CMR技术，这些技术提供了前所未有的 图像质量和诊断价值；这种技术改变了小儿冠心病的CMR临床方式 在我们的中心表演。我们对铁氧托的诊断应用消除了对Gadolinium的任何担忧 在这种续签R01中，在生物组织中积累，我们旨在发展下一代CMR 无浸润性插管，并且可能会减少麻醉/镇静暴露。我们进一步 建议建立我们改进的CMR框架，以发展高级解剖和血流动力学 复杂CHD的建模技术。这些工具共同提供了基于CMR图像的策略来帮助 告知患者的手术计划，并最终预测手术结果。我们将扩大我们的多中心 汇总数据并实现大规模研究的协作。该项目的完成将导致临床 部署新的MRI脉冲序列，图像采集和重建策略以及实验 和计算建模方法。