QUANT. MEASUREMENT OF ATHEROSCLEROTIC PLAQUES IN MRI

定量。

• 批准号: 6527096
• 负责人: CHUN YUAN
• 金额: $ 30.33万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-08-01 至 2005-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6527096
• 关键词: atherosclerosis; atherosclerotic plaque; bioimaging /biomedical imaging; cardiovascular disorder diagnosis; carotid artery; clinical research; diagnosis design /evaluation; endarterectomy; histopathology; human subject; magnetic resonance imaging; myocardial ischemia /hypoxia; noninvasive diagnosis; prognosis; stroke

Cardiovascular disease due to atherosclerosis remains the leading cause of death in the United States. Clinical symptoms and morbidity that result from atherosclerosis disease are due to plaque instability and are manifested as ulceration, thrombosis, and/or intraplaque hemorrhage. Much research has been directed at understanding atherogenesis, the progression of the disease and the final events that lead to heart attack or stroke. However, relatively little is known about how to identify "vulnerable" lesions in vivo noninvasively and to monitor the lesion progression longitudinally. This proposal presents a plan to measure the atherosclerotic plaque features quantitatively using lesion indices and to correlate the lesion indices to the development of clinical symptoms. We will focus our study on advanced lesions at the carotid bifurcation, due to 1) their close association to stroke, 2) their accessibility by high resolution MRI techniques, and 3) the accessibility of carotid samples due to carotid endarterectomy that provide us with an excellent opportunity to verify the MRI results by examining the samples histologically. The long term goal of this project is to identify characteristic magnetic resonance imaging markers for unstable vulnerable atherosclerotic plaque in the carotid artery. At present there are no reliable means to characterize these lesions in terms of features that are associated with vulnerable plaque in vivo. The specific aims are: 1) to develop/optimize lesion indices and 2) to test whether the size of lipid core, the thickness of the fibrous cap, and the extend of neovascularization (as expressed by MR lesion indices) can be associated with clinical symptoms. This project builds on studies that have been performed and that are on going in our laboratory. Improved methods of identifying high-risk plaques will result in better selection of patients for intervention. Development of an accurate, reproducible, and quantitative technique for directly assessing the status and progression of atherosclerotic lesions will significantly reduce the cost of clinical trials. Furthermore, the lesion indices will provide continuous parameter for tracking progression of the lesion rather than a categorical analysis provided by a lesion type evaluation. Lastly, prospective, serial high-resolution MRI of the developing carotid plaque will provide a unique opportunity to examine the processes involved in progression form a stable lesion to vulnerable plaque.

在美国，由动脉粥样硬化引起的心血管疾病仍然是导致死亡的主要原因。 由动脉粥样硬化疾病引起的临床症状和发病率是由于斑块不稳定性，并表现为溃疡、血栓形成和/或斑块内出血。 许多研究都致力于了解动脉粥样硬化的形成、疾病的进展以及导致心脏病发作或中风的最终事件。然而，相对知之甚少的是如何识别“脆弱”的病变在体内非侵入性和监测病变的进展纵向。 本建议提出了一个计划，以衡量动脉粥样硬化斑块的特点，定量使用病变指数和相关的病变指数的发展的临床症状。 我们将重点研究颈动脉分叉处的晚期病变，因为1）它们与卒中密切相关，2）高分辨率MRI技术可及性，3）颈动脉内膜切除术可及性，这为我们提供了通过组织学检查样本来验证MRI结果的绝佳机会。该项目的长期目标是识别颈动脉不稳定易损斑块的特征性磁共振成像标记物。 目前还没有可靠的手段来表征这些病变的特征，与易损斑块在体内。 具体目标是：1）开发/优化病变指数和2）测试脂质核心的大小、纤维帽的厚度和新血管形成的范围（由MR病变指数表示）是否与临床症状相关。该项目建立在我们实验室已经进行和正在进行的研究基础上。 识别高风险斑块的改进方法将导致更好地选择患者进行干预。 开发一种准确、可重复和定量的技术来直接评估动脉粥样硬化病变的状态和进展将显著降低临床试验的成本。 此外，病变指数将提供用于跟踪病变进展的连续参数，而不是由病变类型评价提供的分类分析。 最后，对颈动脉斑块的发展进行前瞻性、系列高分辨率MRI将提供一个独特的机会来检查从稳定病变到易损斑块的进展过程。