Cerebrovascular Physiology of Infants with CHD

描述(申请人提供)：这一职业发展奖将支持丹尼尔·利希特医生成长为一名独立的临床研究员，专门从事儿科脑血管损伤的研究。利赫特博士的主要职业发展目标是建立一个涵盖神经学、危重护理和神经成像领域的多学科研究计划。为了实现这些目标，利希特博士建议物理学家和临床医生合作，开发新的非侵入性方法来测量新生儿的脑血流量(CBF)。通过修改和应用新的成像技术，这项拟议的研究将探讨CBF在患有严重先天性心脏病(CHD)的婴儿获得性脑损伤中的作用。脑血流量是了解、诊断和处理新生儿脑部疾病的重要生理指标，在婴幼儿重症先心病心脏手术前脑损伤中起着关键作用。在之前的研究中，利赫特博士发现，错乱的脑血管生理学与术前结构性脑损伤有关。为了进一步研究这种关联，他建议测量和比较患有CHD的婴儿和没有CHD的婴儿的全球和区域脑容量，并确定这些差异是否与CBF改变有关。利希特博士将使用基于MRI的技术来进行这些测量，并将测试漫反射光学断层扫描(DOT)以进行对比测量。到目前为止，由于缺乏合适的CBF测量技术，有关儿科脑血流灌注的标准数据和疾病数据仍然很少。DOT是对MRI的补充，因为它提供了出色的时间分辨率，并且可以在护理时使用。此外，DOT提供代谢率的并行分析，同时仅牺牲轻微的解剖分辨率。

DESCRIPTION (provided by applicant): This Career Development Award will support the growth of Dr. Daniel Licht into an independent clinical investigator with specialization in pediatric cerebrovascular injury. Dr. Licht's primary career development goal is to establish a multi-disciplinary research program encompassing the fields of neurology, critical care, and neuroimaging. To achieve these goals, Dr. Licht proposes collaborations between physicists and clinicians to develop new non-invasive methods for measuring cerebral blood flow (CBF) in newborn infants. Through modification and application of new imaging technologies, the proposed research will investigate the role of CBF in acquired brain injury in infants with severe congenital heart defects (CHD). CBF represents an important physiologic parameter for the understanding, diagnosis and management of neonatal brain disorders, and plays a pivotal role in brain injury in infants with severe CHD before heart surgery. In previous studies, Dr. Licht has found that deranged cerebrovascular physiology was associated with pre-operative structural brain injury. To further investigate this association, he proposes to measure and compare global and regional brain volumes in infants with CHD to those without CHD, and determine whether these differences are related to an altered CBF. Dr. Licht will use MRI based techniques to make these measurements and will test diffuse optic tomography (DOT) for comparative measurements. To date, both normative and disease data on pediatric brain perfusion remain sparse due to the lack of suitable techniques for CBF measurement. DOT is complimentary to MRI in that it offers excellent temporal resolution and can be applied at the point of care. Furthermore, DOT offers concurrent analysis of metabolic rate while sacrificing only mild anatomic resolution.