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 与心脏的血液供应障碍有关，能够评估心脏的灌注是非常重要的。 心墙。用于评估心肌灌注的常规方法具有许多局限性，包括 相对低的分辨率和提供定量数据的能力差。磁共振成像（MRI） 通过造影剂团注的造影增强的“首过”动力学是非常有前途的 心肌灌注的无创评估方法，分辨率高于传统方法 放射性核素成像方法。然而，目前MRI灌注研究的方法仅是“半定量”的， 由于一些技术上的困难。 我们在绝对测量区域人口方面取得了非常令人鼓舞的初步成果， 心肌灌注，使用新的MRI方法，我们设计，以克服局限性， 常规MRI方法。在拟议的研究中，我们将进一步发展我们的MRI方法， 相关的图像分析方法，用于定量测量心肌灌注。我们将执行一个 对正常受试者进行一系列研究，以确定结果的预期变异范围。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， 方法与用于评估心脏血液供应的常规方法，包括 放射性核素成像、CT血管造影和常规心导管插入术（包括侵入性措施 流量储备）。 所提出的工作的意义在于它有可能实现更精确和更高的分辨率 与目前的常规方法相比，它可以提供对流向心脏壁的血流的评估。这将是 对于辅助治疗决策和随访缺血性心脏病患者的治疗结果非常有用。 心脏病是一种常见而严重的临床疾病。我们提出的定量MRI方法， 用于评估心血管疾病的开发也可能适用于评估 其他重要器官的灌注，如脑，这是中风，并在其他重要的 疾病过程，如癌症，其中疾病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.