Volumetric MRSI Evaluation of Traumatic Brain Injury

创伤性脑损伤的体积 MRSI 评估

• 批准号: 7215621
• 负责人: Andrew A. Maudsley
• 金额: $ 26.73万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7215621
• 关键词: Brain; Brain Edema; Brain Injuries; Brain Stem; Brain region; Choline; Clinical; Clinical assessments; Corpus Callosum; Detection; Development; Diffuse; Diffuse Brain Injury; Disruption; Evaluation; Gray unit of radiation dose; Head; Histocompatibility Testing; Image; Image Analysis; Individual; Injury; Lobe; Localized; Location; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Measurement; Measures; Membrane; Metabolic; Metabolic Marker; Metabolism; Methods; N-acetylaspartate; Neuronal Dysfunction; Neuropsychological Tests; Normal Range; Outcome; Patients; Phase; Pilot Projects; Pontine structure; Process; Protons; Public Health; Research; Research Personnel; Score; Severities; Signal Transduction; Statistical Methods; Testing; Time; Tissues; Traumatic Brain Injury; Water; base; brain metabolism; computerized data processing; density; expectation; experience; functional outcomes; image processing; improved; neuroimaging; spectroscopic imaging; white matter

DESCRIPTION (provided by applicant): The long-term objective of this project is improved evaluation of Traumatic Brain Injury (TBI) using advanced MR neuroimaging methods. TBI represents a major public health problem for which there are currently no objective measures that are able to quantify the severity of injury, or to indicate possible outcomes. Previous studies have shown that Magnetic Resonance Spectroscopy can detect widespread metabolic changes in the brain that correlate with the degree of injury, even in the absence of significant MRI findings. For mild TBI subjects, which represents the largest group of these patients and the most difficult to evaluate, these diffuse metabolic abnormalities may be small in magnitude, though widespread, while it is also known that some brain regions are more susceptible to injury and may have more focal abnormalities, particularly with more severe injury. Therefore, it is hypothesized that improved characterization of this type of brain injury will be obtained by using a) improved detection sensitivity and acquisition from a wide region of the brain, and b) analysis of both focal and diffuse multiparametric metabolic abnormalities, in comparison with normal values. This pilot study will use volumetric proton MR Spectroscopic Imaging (MRSI) at 3 Tesla using phased-array detection, for characterization of metabolic changes associated with mild and moderate closed-head TBI. Measurements will include N-Acetylaspartate and choline, metabolic markers known to be sensitive to neuronal dysfunction and membrane turnover. Results will be correlated with findings from structural MRI, initial clinical assessments, and outcome evaluations, including results of neuropsychological testing. MRSI processing methods will incorporate MRI information to enable metabolite analysis by brain region and tissue type, as well as voxel-based comparisons with normal values. Quantitative neuroimaging measures will be developed that will characterize: 1) which brain locations experience greatest MR-detected metabolic and structural changes; 2) the spatial extent and the degree of metabolic alteration; and 3) which clinical and MR imaging measures best correlate with clinical outcome at 6 months post injury. It is hypothesized that the improved sensitivity and spatial coverage of the spectroscopic measurement and analysis methods will enable improved characterization of mild and moderate injury, and that the metabolic neuroimaging methods will be more sensitive than MRI for evaluation of this brain injury. Relevance of this research: Improved imaging assessment of metabolic changes associated with diffuse brain injury will guide treatment and patient management decisions following brain trauma, as well as providing expectations for long-term consequences of the injury.

描述（由申请人提供）：本项目的长期目标是使用先进的MR神经成像方法改进创伤性脑损伤（TBI）的评价。TBI代表了一个主要的公共卫生问题，目前还没有能够量化损伤严重程度或指示可能结果的客观措施。以前的研究表明，磁共振波谱可以检测到大脑中与损伤程度相关的广泛代谢变化，即使在没有显著MRI结果的情况下。对于轻度TBI受试者，其代表了这些患者中最大的群体并且最难以评估，这些弥漫性代谢异常可能在幅度上较小，尽管广泛，同时还已知一些脑区域更容易受到损伤并且可能具有更多的局灶性异常，特别是对于更严重的损伤。因此，假设通过使用a）改善的检测灵敏度和从脑的广泛区域的采集，和B）与正常值相比，分析局灶性和弥漫性多参数代谢异常，将获得这种类型的脑损伤的改善的表征。该试点研究将使用体积质子磁共振波谱成像（MRSI）在3特斯拉使用相控阵检测，与轻度和中度闭头TBI相关的代谢变化的表征。测量将包括N-乙酰天冬氨酸和胆碱，已知对神经元功能障碍和膜转换敏感的代谢标志物。结果将与结构MRI、初始临床评估和结局评价（包括神经心理学测试结果）的结果相关。MRSI处理方法将结合MRI信息，以实现按脑区域和组织类型的代谢物分析，以及与正常值进行基于体素的比较。将开发定量神经影像学指标，以表征：1）哪些大脑位置经历最大的MR检测到的代谢和结构变化; 2）代谢改变的空间范围和程度; 3）哪些临床和MR影像学指标与损伤后6个月的临床结局最相关。据推测，光谱测量和分析方法的灵敏度和空间覆盖范围的改善将能够改善轻度和中度损伤的表征，并且代谢神经成像方法将比MRI更灵敏地评价这种脑损伤。本研究的相关性：改善与弥漫性脑损伤相关的代谢变化的成像评估将指导脑创伤后的治疗和患者管理决策，并为损伤的长期后果提供预期。