Noninvasive Measurements of Intracranial Pressure

颅内压的无创测量

• 批准号: 6741612
• 负责人: NOAM ALPERIN
• 金额: $ 10.6万
• 依托单位: ALPERIN NONINVASIVE DIAGNOSTICS, INC.
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-18 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6741612
• 关键词: bioimaging /biomedical imaging; blood flow measurement; brain circulation; cerebrospinal fluid; cerebrovascular disorder diagnosis; clinical research; diagnosis design /evaluation; hemodynamics; human subject; intracranial pressure; magnetic resonance imaging; noninvasive diagnosis

DESCRIPTION (provided by applicant): Elevated intracranial pressure (ICP) remains a critical problem in management of patients with neurological problems and is the most common cause of death in these patients. Elevated ICP can be managed and treated if detected at an early stage. Therefore, measurement of ICP is important for diagnosis and treatment decisions. At this time only invasive techniques are available for measurement of ICP. These techniques require physical penetration of the central nervous system (CNS). The objective this project is to develop a clinically viable tool for noninvasive measurement of ICP. The noninvasive measurement of ICP would be at a lower cost and without risk or pain to the patient. Hence, this important clinical parameter would be measured more often and may significantly improve the diagnosis and treatment decisions for patients with neurological problems. The method integrates knowledge from human neuro-physiology, principles of fluid dynamics, and dynamic MRI techniques in a novel technology to noninvasively measure ICP. The technology is innovative as it makes use of the change in intracranial volume (ICV) and ICP that occur naturally during each cardiac cycle rather than altering the state of the CNS by external intervention. The ICP is derived from dynamic MRI measurements of the cerebrospinal fluid (CSF) and blood flow to and from the brain. Recently published work by the PI with animal model, and a small number of patients, demonstrated a good correlation between invasively measured pressure values and values derived noninvasively using the MRI-based method. However, multiple measurements were needed to overcome measurement variability. The objective of this project is to develop a new MRI data acquisition scheme and implement a reliable method for flow quantitation for ICP measurement. These steps would accelerate the transfer of this technology from the research phase to become a clinically viable tool. The proposed specific aims are: 1. Develop MRI data acquisition protocol for simultaneous measurement of slow (CSF) and fast (blood) flow dynamics. 2. Implement an automated method to identify the blood and CSF lumens boundary for reproducible volumetric flow measurements. 3. Quantify and demonstrate improved reproducibility of the volumetric flow rates and the resulting ICP values.

描述（由申请方提供）：颅内压升高（ICP）仍然是神经系统疾病患者管理中的一个关键问题，也是这些患者最常见的死亡原因。如果在早期发现，可以管理和治疗ICP升高。因此，测量ICP对于诊断和治疗决策是重要的。目前，只有侵入性技术可用于测量ICP。这些技术需要物理穿透中枢神经系统（CNS）。 本项目的目的是开发一种临床上可行的工具，用于无创测量ICP。ICP的非侵入性测量将以较低的成本并且对患者没有风险或痛苦。因此，这一重要的临床参数将被更频繁地测量，并可能显着改善神经系统问题患者的诊断和治疗决策。该方法将人类神经生理学、流体动力学原理和动态MRI技术的知识整合到一种新技术中，以非侵入性方式测量ICP。该技术是创新的，因为它利用了在每个心动周期中自然发生的颅内容积（ICV）和ICP的变化，而不是通过外部干预改变CNS的状态。ICP是从脑脊液（CSF）和流入和流出大脑的血流的动态MRI测量得出的。 PI最近发表的关于动物模型和少量患者的研究表明，有创测量的压力值与使用基于MRI的方法无创导出的值之间具有良好的相关性。然而，需要多次测量来克服测量变异性。 本计画的目的是发展一种新的磁振造影资料撷取方法，并实施一种可靠的颅内压流量定量方法。这些步骤将加速将这项技术从研究阶段转移到临床可行的工具。 拟议的具体目标是： 1.制定MRI数据采集方案，用于同时测量慢（CSF）和快（血液）流动动力学。 2.采用自动化方法识别血液和CSF管腔边界，以进行可重现的体积流量测量。 3.量化并证明体积流速和所得ICP值的重现性得到改善。

项目成果

Inter- and intra-rater reliability of blood and cerebrospinal fluid flow quantification by phase-contrast MRI.

• DOI: 10.1002/jmri.24013
• 发表时间: 2013-09
• 期刊: JOURNAL OF MAGNETIC RESONANCE IMAGING
• 影响因子: 4.4
• 作者: Koerte, Inga;Haberl, Caroline;Schmidt, Michael;Pomschar, Andreas;Lee, Sang;Rapp, Petra;Steffinger, Denise;Tain, Rong-Wen;Alperin, Noam;Ertl-Wagner, Birgit
• 通讯作者: Ertl-Wagner, Birgit