Quantitative Myocardial Perfusion in Assessment with MRI

心脏病是西方世界发病率和死亡率的主要原因。因为这主要是 与心脏供血障碍有关，能够评估心脏的血流灌注是非常重要的。 心壁。传统的心肌灌注评估方法有许多局限性，包括 分辨率相对较低，提供定量数据的能力较差。磁共振成像(MRI) 团注造影剂增强对比度的“首过”动力学是一种很有前途的方法。 比常规方法分辨率更高的无创性心肌灌注评价方法 放射性核素成像方法。然而，目前的MRI血流灌注研究方法仅是“半定量的”， 由于几个技术困难。 我们在对区域和区域进行绝对衡量方面取得了非常令人鼓舞的初步成果。 心肌灌注，使用我们设计的新的MRI方法，以克服 常规的核磁共振成像方法。在拟议的研究中，我们将进一步发展我们的磁共振成像方法，并 相关的图像分析方法，用于定量测量心肌灌注。我们将表演一场 对正常受试者进行的一系列研究，以确定结果的预期变异性范围。我们还将 对冠状动脉疾病患者进行一系列研究，比较我们的MRI结果 评估心脏血液供应的方法与传统方法不同，包括 放射性核素成像、CT血管造影术和常规心导管检查(包括侵入性措施 流量储备)。 拟议工作的意义在于它有可能实现更准确和更高的分辨率 对流向心壁的血流的评估比目前的传统方法所能提供的更好。这将是 对缺血性心脏病患者的治疗决策和跟踪治疗结果非常有用 心脏病，一种常见而严重的临床疾病。我们提出的定量磁共振成像方法 用于评估心血管疾病的开发也可能适用于对 其他重要器官的灌注，如大脑，这是中风的原因，以及在其他重要的 疾病过程，如癌症，其中疾病的演变可能与血流有关。

Heart disease is the leading cause of morbidity and mortality in the Western World. As this is mostly related to disorders of the blood supply to the heart, it is very important to be able to assess the perfusion of the heart wall. Conventional methods for assessing myocardial perfusion have many limitations, including relatively low resolution and poor ability to provide quantitative data. Magnetic resonance imaging (MRI) of the "first-pass" kinetics of contrast enhancement by a bolus injection of contrast agent is a very promising method for noninvasive assessment of myocardial perfusion, with higher resolution than conventional radionuclide imaging methods. However, current approaches to MRI perfusion studies have only been "semiquantitative", due to several technical difficulties. We have been achieving very encouraging initial results in making absolute measurements of regional myocardial perfusion, using novel MRI methods that we have designed to overcome the limitations of conventional MRI approaches. In the proposed research, we will further develop our MRI methods, and the associated image analysis methods, for quantitatively measuring myocardial perfusion. We will perform a series of studies on normal subjects to establish the expected range of variability of the results. We will also perform a series of studies of patients with coronary artery disease, comparing the results of our MRI methods with those of conventional methods used to assess the blood supply to the heart, including radionuclide imaging, CT angiography and conventional cardiac catheterization (including invasive measures of flow reserve). The significance of the proposed work is its potential to achieve more accurate and higher resolution assessments of blood flow to the heart wall than current conventional methods can provide. This would be very useful for aiding treatment decisions and for following the results of therapy in patients with ischemic heart disease, a common and serious clinical condition. The quantitative MRI methods we propose to develop for the assessment of cardiac vascular disease may also be applicable to assessment of the perfusion of other important organs, such as the brain, which is subject to stroke, and in other important disease processes, such as cancer, where the disease evolution may be related to blood flow.