COMPREHENSIVE DIAGNOSIS OF ISCHEMIC HEART DISEASE BY MRI

开发了一种新的实时、交互式心脏磁共振成像系统(RTIS)。RTIS允许连续动态采集、交互选择任何扫描平面，并以16帧/秒(6个完整图像/秒)的速度实时显示图像，而无需心脏门控或呼吸屏气。RTI的临床试验表明，该系统提供了临床上可靠的左心功能评估。这项提议的目标是利用RTIS技术开发一种新的成像方案，用于全面诊断缺血性心脏病。RTIS平台将通过冠状动脉、应力诱导的室壁运动和心肌灌注的成像序列来增强。第一阶段将专注于优化每个成像序列。每个优化都将通过与各自的诊断黄金标准进行系统比较来验证。高分辨率冠状动脉成像序列将允许立即对所需冠状动脉进行筛查、定位和可视化。30个完整图像/秒的帧速率将提供心动过速范围内应力诱发的室壁运动的成像。心脏门控单次激发成像将能够在多个平面上快速获取每个收缩期的几帧，以覆盖整个心脏进行第一次通过的灌注成像。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，3个成像序列将被无缝地集成到RTIS中，以测试快速和强大的综合心血管诊断系统(CVMR)的临床应用。磁共振成像的广泛的组织对比机制为心血管成像创造了巨大的潜力。已开发出稳健的成像序列来显示用于诊断心肌缺血的生理参数。这项研究计划的主要目的是开发一种先进的、集成的成像系统来测试这种综合方法是否会增强对缺血性心脏病的非侵入性诊断的假设。最终的产品将是一个诊断系统，它将最大限度地提高MR组织对比特性，并结合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.