Improving SENSE MRI for Spiral and Echo-planar Imaging in Stroke

描述（由申请人提供）：动机-缺血性卒中是一种常见且通常具有破坏性的疾病，仍然是全球死亡和残疾的主要原因。成功的治疗将对中风发病率产生巨大影响，并将减少与这种使人衰弱的疾病相关的社会经济负担。目前已有大量数据表明，基于MR的DWI、PWI和MRA可用于识别特别可能受益于再灌注治疗而非受到再灌注治疗损害的患者亚组。多层螺旋CT（MDCT）的进步也改善了急性卒中患者的诊断评价，对两种模式的最佳检查进行比较评价是及时的。目标-该项目有一个技术开发部门，其中进一步改进了DWI、PWI和CE-MRA的MRI方法，还有一个临床部门，其中在急性卒中患者中评价了这些方法，并将MRI的诊断灵敏度和特异性以及临床产率与最佳可用MDCT方法（CT、CTP、CTA）进行了比较。方法-平行成像将是这个项目的一个主要主题。具体而言，螺旋、PROPELLER和笛卡尔数据的采集和快速重建方法将得到改进。将开发DWI和PWI方法，以改善定量，同时减少几何失真和运动伪影，并显着提高空间分辨率。将开发新的对比增强MRA采集方案和重建方法。DWI、PWI和CE-MRA的开发之后将进行广泛的体模和志愿者研究，以评估图像质量。将在120例连续急性卒中患者（症状发作后6- 12小时内）中比较这些优化MR方法的诊断灵敏度和特异性以及临床产率，并采用64通道MDCT提供的最佳灌注和血管造影方法。意义-这项研究工作的成功将有助于显着改善多线圈并行成像采集和重建方法。在临床上，我们预计这项前瞻性研究将提供一个更好的了解MRI和MDCT的诊断能力成像急性脑卒中患者。此外，它将提供工具，以帮助确定谁将受益于再灌注治疗的患者，并排除谁是在高风险的再灌注相关脑出血的患者。

DESCRIPTION (provided by applicant): MOTIVATION - Ischemic stroke is a common and often devastating condition that continues to be a leading cause of death and disability worldwide. Successful treatment will have a great impact on stroke morbidity and will reduce the socio-economic burden associated with this debilitating disease. Considerable data are now available indicating that MR-based DWI, PWI, and MRA are useful for identifying subgroups of patients who are particularly likely to benefit from, rather than be harmed by, reperfusion therapy. The advancement of multi-detector CT (MDCT) has also improved the diagnostic evaluation of acute stroke patients and a comparative evaluation of optimal exams from both modalities is timely. AIMS - This project has a technology development arm in which MRI methods for DWI, PWI and CE- MRA are improved further, and a clinical arm in which these methods are evaluated in acute stroke patients and MRI's diagnostic sensitivity and specificity as well as clinical yield is compared with the best available MDCT methods (CT, CTP, CTA). METHODS - Parallel imaging will be a major theme of this project. Specifically, acquisition and fast reconstruction methods for spiral, PROPELLER, and Cartesian data will be improved. DWI and PWI methods will be developed to improve quantitation while simultaneously reducing geometric distortions and motion artifacts and significantly improving spatial resolution. New contrast-enhanced MRA acquisition schemes and reconstruction methods will be developed. The development of DWI, PWI, and CE-MRA will be followed by extensive phantom and volunteer studies to assess the image quality. The diagnostic sensitivity and specificity as well as the clinical yield of these optimized MR methods will be compared in 120 consecutive acute stroke patients (within 6-i2hrs after onset of symptoms) with the most optimal perfusion and angiographic methods afforded by a 64-channel MDCT. SIGNIFICANCE - The success of this research effort will serve to significantly improve multi-coil parallel imaging acquisition and reconstruction methods. Clinically, we anticipate that this prospective study will provide a better understanding of the diagnostic capability of both MRI and MDCT for imaging acute stroke patients. Moreover, it will provide tools to help identify patients who will benefit from reperfusion therapies and to exclude patients who are at high risk for reperfusion-related brain hemorrhage.