Magnetic resonance based quantitative assessment of myocardial microvascular and microstructural function using STEAM-tIVIM

使用 STEAM-tIVIM 基于磁共振的心肌微血管和微结构功能定量评估

• 批准号: EP/X014010/1
• 负责人: Andrew Scott
• 金额: $ 94.52万
• 依托单位: Imperial College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FX014010%2F1
• 关键词: Magnetic; resonance; based; quantitative; assessment

An inadequate blood supply to the heart, often causing chest pain during exercise, is typically caused by narrowing of the blood vessels that supply the heart muscle. However, in around half of these patients no severe narrowing is visible in pictures of the vessels and the pain is often due to disease in the microscopic blood vessels of the heart. This condition is known as microvascular dysfunction. We will develop a new type of MRI scan known as STEAM-tIVIM that provides information on both the blood flow in the microscopic vessels and the microscopic structure of the heart muscle. This method detects the random movement of water molecules as they move around inside and outside the cells of our bodies. As the microscopic vessels of the heart have many twists and turns in a short distance, the movement of blood appears random and can also be detected with STEAM-tIVIM. We will be able to detect the direction of blood flow and the direction that the brick-like muscle cells are pointing in. No other method exists that provides this information without removing a piece of the heart and studying it under a microscope. Our MRI technique uses no radiation or injection of dyes.We will assess how sensitive our MRI scan is to changes in blood flow by adding microscopic blood vessels to a computer model of the heart muscle on a microscopic scale that we have developed. This model will tell us what the smallest change in blood flow that we will be able to detect using our scans is and what the scanner settings for the highest sensitivity will be. We will programme the MRI scanner to collect the data and turn this stream of numbers into the pictures showing how measures such as the flow of blood within microscopic blood vessels, how much blood is in the vessels and the direction of the blood vessels vary across the heart. From these same scans, other pictures will show how the heart muscle cells are aligned. Our programmes will be tested using our computer model, then by scanning test objects (bottles of water-based liquids) and then 10 volunteers to check how well the scans work in a beating heart. These scans take around 1 hour, there is no radiation and we monitor the heartbeat using an ECG to allow us scan in the part of the heartbeat when the heart is moving least. To confirm how sensitive the MRI scan pictures are to changes in the flow of blood through the microscopic blood vessels we will scan pigs' hearts. The hearts come from butchered pigs and would otherwise be thrown away. We will pump blood-like liquid through the vessels of the pig hearts while we scan. By varying the flow of liquid we can check how sensitive our methods are. We will also add a medicine to the liquid which makes arteries wider in healthy hearts, mimicking exercise to check that we can detect the extra blood in the heart with our MRI scan pictures when we give this medicine. Our new MRI scan will be compared to another type of MRI scan that is available at the moment, but needs injection of a dye into the heart so is not possible in some patients. Scientists are also concerned about the build-up of this dye in the body when patients have many scans using it.Finally, we will check that the MRI scan can detect changes in blood flow in the heart muscle of patients with microvascular dysfunction. Many patients who doctors think have microvascular dysfunction have MRI scans as part of their normal care and we will invite them to come back for a second scan. In this second scan, we will run our new STEAM-tIVIM method twice, once while the patient is injected with the medicine used to simulate exercise. We will scan 20 patients and scan the same number of volunteers of a similar age and male to female ratio as the patients. We believe that when we simulate exercise, the increase in blood flow to the heart muscle measured in patients will be smaller than in the volunteers.

心脏的血液供应不足，通常会导致运动期间的胸痛，通常是由供应心肌的血管变窄引起的。然而，在这些患者中，大约有一半的人在血管照片中看不到严重的狭窄，疼痛通常是由于心脏的微观血管中的疾病。这种情况被称为微血管功能障碍。我们将开发一种称为STEAM-tIVIM的新型MRI扫描，它可以提供有关微观血管中血流和心肌微观结构的信息。这种方法检测水分子在我们身体细胞内外移动时的随机运动。由于心脏的微观血管在短距离内有许多曲折，血液的运动似乎是随机的，也可以用STEAM-tIVIM检测到。我们将能够检测到血液流动的方向以及砖状肌肉细胞所指向的方向。没有其他方法可以提供这些信息，而不需要取出一片心脏并在显微镜下研究。我们的MRI技术不使用辐射或注射染料。我们将通过在我们开发的微观尺度上的心肌计算机模型中添加微观血管来评估我们的MRI扫描对血流变化的敏感性。该模型将告诉我们，我们将能够使用扫描检测到的血流的最小变化是什么，以及扫描仪的最高灵敏度设置是什么。我们将对MRI扫描仪进行编程，以收集数据，并将这些数字流转化为图片，显示微观血管内的血液流动，血管中的血液量以及血管的方向等测量如何在心脏中变化。从这些相同的扫描，其他图片将显示心肌细胞是如何排列的。我们的程序将使用我们的计算机模型进行测试，然后通过扫描测试对象（瓶装水基液体），然后10名志愿者检查扫描在跳动的心脏中的工作情况。这些扫描大约需要1小时，没有辐射，我们使用ECG监测心跳，以便在心脏运动最少的时候扫描心跳部分。为了证实MRI扫描图像对通过微观血管的血流变化的敏感性，我们将扫描猪的心脏。这些心脏来自屠宰的猪，否则就会被扔掉。我们将在扫描的同时，将血液样的液体泵入猪心的血管。通过改变液体的流量，我们可以检查我们的方法有多灵敏。我们还将在液体中加入一种药物，使健康心脏的动脉变宽，模仿运动，检查我们是否可以在服用这种药物时通过MRI扫描图片检测到心脏中的额外血液。我们的新MRI扫描将与目前可用的另一种MRI扫描进行比较，但需要将染料注射到心脏中，因此在某些患者中不可能。科学家们也担心这种染料在体内的积累，当病人有许多扫描使用它。最后，我们将检查核磁共振扫描可以检测到微血管功能障碍患者的心肌血流量的变化。许多医生认为有微血管功能障碍的患者都有MRI扫描作为他们正常护理的一部分，我们将邀请他们回来进行第二次扫描。在第二次扫描中，我们将运行我们的新STEAM-tIVIM方法两次，一次是在患者注射用于模拟运动的药物时。我们将扫描20名患者，并扫描与患者年龄和男女比例相似的相同数量的志愿者。我们相信，当我们模拟运动时，在患者中测量到的心肌血流量的增加将小于志愿者。

项目成果

Functional Imaging and Modeling of the Heart - 12th International Conference, FIMH 2023, Lyon, France, June 19-22, 2023, Proceedings

心脏功能成像和建模 - 第 12 届国际会议，FIMH 2023，法国里昂，2023 年 6 月 19-22 日，会议记录

• DOI: 10.1007/978-3-031-35302-4_6
• 发表时间: 2023
• 作者: Alemany I

STEAM-SASHA: a novel approach for blood- and fat-suppressed native T1 measurement in the right ventricular myocardium

• DOI: 10.1007/s10334-023-01141-8
• 发表时间: 2024-01
• 期刊: Magma (New York, N.y.)
• 作者: M. Roehl;Miriam Conway;S. Ghonim;Pedro F. Ferreira;S. Nielles-Vallespin;Sonya V. Babu-Narayan;D. Pennell;Peter Gatehouse;Andrew D Scott

Referenceless Nyquist ghost correction outperforms standard navigator-based method and improves efficiency of in vivo diffusion tensor cardiovascular magnetic resonance

无参考奈奎斯特重影校正优于基于标准导航器的方法，并提高了体内扩散张量心血管磁共振的效率

• DOI: 10.1002/mrm.30012
• 发表时间: 2024
• 期刊: Magnetic Resonance in Medicine
• 影响因子: 3.3
• 作者: Huo Z

Deep learning-based diffusion tensor cardiac magnetic resonance reconstruction: a comparison study

• DOI: 10.1038/s41598-024-55880-2
• 发表时间: 2024-03-07
• 期刊: SCIENTIFIC REPORTS
• 影响因子: 4.6
• 作者: Huang，Jiahao;Ferreira，Pedro F.;Yang，Guang
• 通讯作者: Yang，Guang