HIGH FIELD MRI AND THE LABYRINTH: VESTIBULAR STIMULATION AND NEW IMAGING TECHNIQUES

摘要 布莱恩·沃德博士是麻省理工学院耳鼻咽喉头颈外科的助理教授。 约翰霍普金斯医学院，在那里他的临床实践致力于前庭疾病，耳科 和神经病学。他正在寻求一项有指导的职业发展奖，以填补 使用核磁共振对内耳进行成像。他的长期目标是建立一个独立的研究项目， 致力于利用影像来提高头晕和失衡患者的诊断和治疗水平。这个 候选人建议扩展他之前研究强磁场对人体的生理影响的工作。 利用内耳前庭系统对健康栗鼠和人类迷路中的液体流动进行成像。这个 培训计划使沃德博士沉浸在科室的多学科研究和临床环境中 约翰霍普金斯大学医学院放射学、神经学、生物医学工程和耳鼻喉科 医学。具体的培训目标包括：(1)接受关于核磁共振的物理和图像如何的培训 获得，(2)完成核磁共振安全培训，并使用成像方式进行前瞻性研究，(3) 在研究的道德和负责任的行为方面进行额外的培训，以及(4)整合他的临床 随着他发展成为一名独立的调查员，他接受了前庭疾病方面的培训。 高磁场磁共振成像可以提高图像的空间和时间分辨率，因为 信噪比；然而，这些核磁共振机器也会导致人类头晕和眩晕。我们 先前显示，所有健康的人类在核磁共振检查中都有眼球震颤，并假设这是由于 迷宫中的洛伦兹力。拟议研究的具体目的是：(1)测试 洛伦兹力引起流体流动的假说，可在活体中使用相位对比/流动观察到 核磁共振成像，(2)开发和实施一种经济有效的对策，将眩晕的风险降至最低 (3)7T和3T MRI结合解剖成像人体迷路 和血流成像序列。这项研究将在目标1中涉及龙猫，并招募健康人 目标2和目标3的参与者。拟议研究计划的完成将为 强MRI中的头晕，一种降低MRI中头晕影响的低成本方法，无论 磁场强度，并支持改进的MRI可以提供更高分辨率的迷路图像。 在这个奖项结束时，候选人将处于有利地位，能够成功地竞争资金， 掌握相关知识和技能，成为使用高强度核磁共振识别新技术的领导者 前庭病理生理学，并改进对导致头晕和眩晕的常见情况的诊断。

ABSTRACT Dr. Bryan Ward is an assistant professor in the department of Otolaryngology-Head & Neck Surgery at the Johns Hopkins School of Medicine, where he is dedicating his clinical practice to vestibular disorders, otology and neurotology. He is seeking a mentored career development award in order to fill knowledge gaps in imaging of the inner ear using MRI. His long-term goal is establishing an independent research program that is devoted to using imaging to improve the diagnosis and treatment of patients with dizziness and imbalance. The candidate proposes expanding on his prior work studying the physiologic effects of strong magnetic fields on the inner ear vestibular system to imaging the fluid flow in the labyrinth of healthy chinchillas and humans. The training plan immerses Dr. Ward in the multidisciplinary research and clinical environments in the departments of radiology, neurology, biomedical engineering and otolaryngology at the Johns Hopkins University School of Medicine. Specific training goals include: (1) receive training in the physics of MRI and how images are acquired, (2) complete training in MRI safety and performing prospective studies using imaging modalities, (3) pursue additional training in the ethical and responsible conduct of research, and (4) integrate his clinical training in vestibular disorders with this knowledge as he develops into an independent investigator. High magnetic field MRIs can increase spatial and temporal resolution of images as a result of increased signal-to-noise ratio; however, these MRI machines also cause dizziness and vertigo in humans. We previously showed that all healthy humans have nystagmus in an MRI and hypothesized that this is due to a Lorentz force occurring in the labyrinth. The specific aims of the proposed research are to: (1) test the hypothesis that a Lorentz force causes fluid flow that can be observed in vivo using phase contrast/flow imaging in MRI, (2) to develop and implement a cost-effective countermeasure that minimizes the risk of vertigo in high-strength MRI fields, and (3) to image the human labyrinth in 7T and 3T MRI combining anatomic and flow imaging sequences. The study will involve chinchillas in aim 1 and the recruitment of healthy human participants in aims 2 and 3. Completion of the proposed research plan will provide evidence for the cause of dizziness in strong MRI, a low-cost method to mitigate the effects of dizziness in an MRI regardless of the magnetic field strength, and support that improved MRI can provide higher resolution images of the labyrinth. At the conclusion of this award, the candidate will be well-positioned to compete successfully for funding, having acquired relevant knowledge and skills to become a leader in using high-strength MRI to identify new vestibular pathophysiology and improve diagnosis of common conditions that cause dizziness and vertigo.