COMPREHENSIVE DIAGNOSIS OF ISCHEMIC HEART DISEASE BY MRI

研制了一种新型实时、交互式心脏磁共振成像系统（RTIS）。RTIS允许连续动态采集，任何扫描平面的交互式选择，以及16帧/秒（6张完整图像/秒）的实时图像显示，无需心脏门控或呼吸屏气。RTIS的临床试验表明，该系统提供了临床上可靠的左室功能评估。本提案的目标是利用RTIS技术开发一种新的成像方案，用于缺血性心脏病的全面诊断。RTIS平台将通过冠状动脉、应力诱导壁运动和心肌灌注的成像序列来增强。第一阶段将重点优化每个成像序列。每个优化将通过与各自诊断金标准的系统比较来验证。高分辨率的冠状动脉成像序列将允许立即筛选，定位和可视化所需的冠状动脉。帧率为30张完整的图像/秒将提供在心动过速范围内应力引起的壁面运动成像。心脏门控单次成像将能够在多个平面上快速获取每个收缩期的几帧图像，以覆盖整个心脏进行第一次灌注成像。第二阶段将包括每个优化序列的前瞻性临床试验。在最后阶段，这3种成像序列将无缝集成到RTIS中，以测试快速而强大的综合心血管诊断系统（CVMR）的临床实用性。MRI广泛的组织对比机制为心血管成像创造了巨大的潜力。鲁棒成像序列已开发显示生理参数，以诊断心脏缺血。本研究计划的主要目标是开发一种先进的集成成像系统，以测试这种综合方法是否会增强缺血性心脏病的非侵入性诊断。最终产品将是一个诊断系统，该系统将最大限度地提高MR组织对比度特性，并具有实时交互能力和简单、直观的用户界面。CVMR将展示创新技术向心血管医学的最佳转移。

A new real-time, interactive cardiac magnetic resonance imaging system (RTIS) has been developed. The RTIS allows continuous dynamic acquisition, interactive selection of any scan plane, and real-time image display at 16 frames/second (6 complete images/second) without cardiac gating or respiratory breath-holding. A clinical trial of the RTIS demonstrates that the system provides clinically reliable evaluation of LV function. The goal of this proposal is to use the RTIS technology to develop a new imaging protocol for a comprehensive diagnosis of ischemic heart disease. The RTIS platform will be augmented by imaging sequences for coronary artery, stress-induced wall motion, and myocardial perfusion. The first phase will focus on optimizing each imaging sequence. Each optimization will be validated by systematic comparison to the respective diagnostic gold standard. High-resolution coronary artery imaging sequence will allow immediate screening, localization, and visualization of the desired coronary artery. Frame rate of 30 complete images/second will provide imaging of stress induced wall-motion in tachycardia range. Cardiac-gated single shot imaging will enable rapid acquisition of several frames per systole over multiple planes to cover the entire heart for first- pass perfusion imaging. The second phase will consist of a prospective clinical trial of each optimized sequence. During the final phase, the 3 imaging sequences will be integrated seamlessly into the RTIS to test the clinical utility of a rapid and robust comprehensive cardiovascular diagnostic system (CVMR). The wide range of tissue contrast mechanism of MRI creates a huge potential in cardiovascular imaging. Robust imaging sequences have been developed to display physiologic parameters to diagnose cardiac ischemia. The major thrust of this research plan is to develop an advanced, integrated imaging system to test the hypothesis whether such comprehensive approach will enhance non-invasive diagnosis of ischemic heart disease. The final product will be a diagnostic system that maximizes the MR tissue contrast properties coupled with real-time interactive capabilities and easy, intuitive user-interface. The CVMR will demonstrate optimal transfer of innovative technology to cardiovascular medicine.