3D Free-breathing MRI with High Scan Efficiency for Assessment of Cardiovascular Disease: Combining Acceleration and Motion Correction Techniques

用于评估心血管疾病的高扫描效率 3D 自由呼吸 MRI：结合加速和运动校正技术

• 批准号: MR/L009676/1
• 负责人: Claudia Prieto
• 金额: $ 48.47万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2014
• 资助国家: 英国
• 起止时间: 2014 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FL009676%2F1
• 关键词: 3D; Free; breathing; MRI; Scan

Coronary artery disease (CAD) is the leading single cause of morbidity and mortality in the Western world, causing over 65.000 deaths every year in England. Improving the treatment and outcome of cardiovascular disease is one of the main priorities of the National Health Service in the UK. CAD reduces the blood supply to the cardiac muscle and can lead to chest pain (angina) or heart attack. Its diagnosis is currently performed by invasive, ionizing, and potentially harmful X-ray cardiac catheterization procedures. Magnetic Resonance Imaging (MRI) is a very promising non-invasive tool for early risk assessment, guidance of therapy and treatment monitoring of CAD. Clinical research studies have shown the potential of perfusion, cardiac function, late gadolinium enhancement (LGE; infarct) and coronary MR angiography (CMRA) for the assessment of CAD. However, technical developments are still needed to allow MRI achieving similar diagnostic accuracy as the current clinical gold standard. Two major challenges in cardiovascular MRI are 1) image quality degradation due to respiratory motion, and 2) long scan times resulting from the required high-spatial resolution. Both can lead to non-diagnostic image quality and a low patient throughput resulting in high operation costs if not adequately addressed. Current developments that facilitate these problems still suffer from either long acquisition times or require acquisitions under multiple breath-holds, which can be difficult in very sick patients and lead to a reduced diagnostic accuracy.LGE and CMRA protocols are particularly affected by these limitations. LGE yields images with a high contrast between viable and fibrotic/infarcted myocardial tissue and requires high resolution to accurately measure infarct size and transmurality as it has important implications on treatment decisions and patient prognosis. Similarly high-resolution 3D acquisitions are required in CMRA to accurately visualize coronary stenosis. The most common approach to detect and correct for respiratory motion in free-breathing LGE and CMRA imaging is the use of diaphragmatic navigator echoes to gate the MR acquisition. With this approach the MR data is acquired only when the respiratory signal coincides with a predefined acceptance window of the breathing cycle (e.g. end-expiration) with all other data being rejected. Small gating windows of 3 to 5mm allow to reduce motion artifacts but lead to prolonged acquisition times, which may even result in scan abortion in patients with highly irregular breathing patterns. Current approaches often lead to long acquisition times and/or suboptimal image quality due to residual respiratory motion.In this proposal we aim to develop, implement and test the clinical feasibility of an efficient (shorter scan time) and robust (neither planning nor patient collaboration required) respiratory motion compensation framework for LGE and CMRA. This framework should allow to reduce the acquisition time of current CMRA and LGE protocols from ~10 min to less than 3 min. We hypothesize that this can be achieved by developing a new 3D approach that combines novel data sampling schemes, novel undersampling reconstruction techniques and a mathematical framework for simultaneous undersampled image reconstruction and motion correction of the free-breathing acquired data. In the near future this project will benefit the scientific research community working in the field of coronary artery imaging and myocardial tissue characterization, as well as those working on MRI reconstruction and motion correction. Moreover, it will strengthen the UK's already strong role in medical imaging research. In the long term, the beneficiaries of this research may be patients with coronary artery disease who will benefit from efficient and accurate non-invasive diagnostic tests. However, a broad clinical application would require subsequent clinical studies in a larger number of patients.

冠状动脉疾病（CAD）是西方世界发病率和死亡率的主要单一原因，在英国每年导致超过65.000人死亡。改善心血管疾病的治疗和预后是英国国家卫生服务的主要优先事项之一。CAD减少了心肌的血液供应，并可能导致胸痛（心绞痛）或心脏病发作。目前，其诊断是通过侵入性，电离和潜在有害的X射线心导管插入术进行的。磁共振成像（MRI）是一种非常有前途的非侵入性工具，用于CAD的早期风险评估、治疗指导和治疗监测。临床研究表明灌注、心功能、晚期钆增强（LGE;梗死）和冠状动脉MR血管造影（CMRA）可用于评估CAD。然而，仍然需要技术发展，以使MRI达到与当前临床金标准相似的诊断准确性。心血管MRI中的两个主要挑战是1）由于呼吸运动导致的图像质量下降，以及2）由于所需的高空间分辨率导致的长扫描时间。如果不充分解决，这两者都可能导致非诊断图像质量和低患者吞吐量，从而导致高手术成本。目前的发展，促进这些问题仍然遭受要么长采集时间或需要在多次屏气下采集，这可能是困难的，在病情严重的患者，并导致降低诊断准确性。LGE和CMRA协议特别受到这些限制。LGE产生的图像在存活和纤维化/梗死心肌组织之间具有高对比度，并且需要高分辨率来准确测量梗死尺寸和透壁性，因为它对治疗决策和患者预后具有重要意义。同样，CMRA需要高分辨率3D采集，以准确显示冠状动脉狭窄。在自由呼吸LGE和CMRA成像中检测和校正呼吸运动的最常见方法是使用横膈膜导航回波来门控MR采集。利用该方法，仅当呼吸信号与呼吸周期（例如呼气末）的预定义接受窗口一致时才采集MR数据，而所有其他数据被拒绝。3至5 mm的小门控窗口可以减少运动伪影，但会导致采集时间延长，甚至可能导致呼吸模式高度不规则的患者扫描失败。目前的方法往往会导致长的采集时间和/或次优的图像质量，由于残留的呼吸motion.In这个建议，我们的目标是开发，实施和测试的临床可行性的一个有效的（更短的扫描时间）和强大的（既不需要规划，也不需要病人的合作）呼吸运动补偿框架LGE和CMRA。这个框架应该允许减少当前CMRA和LGE协议的采集时间从~10分钟到小于3分钟。我们假设，这可以通过开发一种新的3D方法来实现，该方法结合了新颖的数据采样方案，新颖的欠采样重建技术和数学框架，用于同时欠采样图像重建和运动校正的自由呼吸采集数据。在不久的将来，该项目将有利于在冠状动脉成像和心肌组织定征领域工作的科研界，以及那些从事MRI重建和运动校正的科研界。此外，它将加强英国在医学成像研究领域已经很强的作用。从长远来看，这项研究的受益者可能是冠状动脉疾病患者，他们将受益于有效和准确的非侵入性诊断测试。然而，广泛的临床应用将需要在大量患者中进行后续临床研究。

项目成果

Assessment of respiratory motion-resolved and nonrigid motion-corrected 3D Cartesian coronary MRA

呼吸运动分辨和非刚性运动校正 3D 笛卡尔冠状动脉 MRA 的评估

• 发表时间: 2018
• 作者: Correia T

Five-minute whole-heart coronary MRA with sub-millimeter isotropic resolution, 100% respiratory scan efficiency, and 3D-PROST reconstruction.

• DOI: 10.1002/mrm.27354
• 发表时间: 2019-01
• 期刊: Magnetic resonance in medicine
• 影响因子: 3.3
• 作者: Bustin A;Ginami G;Cruz G;Correia T;Ismail TF;Rashid I;Neji R;Botnar RM;Prieto C
• 通讯作者: Prieto C

Accelerated 3D coronary MRA using non-rigid motion corrected regularized reconstruction

使用非刚性运动校正正则化重建加速 3D 冠状动脉 MRA

• 发表时间: 2016
• 作者: Correia T

Undersampled Motion Compensated LOST Reconstruction for Free-Breathing Coronary MRA

自由呼吸冠状动脉 MRA 的欠采样运动补偿 LOST 重建

• 发表时间: 2015
• 作者: Aitken AP

Imaging of the Cardiovascular System, Thorax, and Abdomen

心血管系统、胸部和腹部成像

• DOI: 10.1201/b19675-2
• 发表时间: 2016
• 作者: Chiribiri A