Cine-DENSE MRI to study right-and left ventricular forms of cardiomyopathy in SA

描述（由申请人提供）：这项研究将主要在南非开普敦大学 (UCT) 和开普敦 Groote Schuur 医院 (GSH) 与 Mayosi、Meintjes 和 Smedema 博士合作进行，作为 NIH 拨款 #1 R01 EB001763 的延伸。总体目标是将电影密集（刺激回声位移编码）MRI 用于研究左心室和右心室心肌病（在撒哈拉以南非洲地区尤其普遍）中出现的室壁运动异常，并开发高度自动化的算法来定量分析此类图像。心肌病是非洲所有心血管疾病中最大的挑战，因为心肌病在仍然受到饥荒和瘟疫疾病困扰的社会中更为流行；由于在资源匮乏的环境中缺乏专门的心脏病学调查，导致诊断困难；缺乏有效的干预措施，例如心脏移植；以及与这些通常不可逆转的心肌疾病相关的高死亡率。心肌病中的室壁运动异常可能是临床可检测到的心力衰竭之前最早的功能异常，并且可以提供有关心脏收缩功能的直接信息。以前的壁运动成像技术要么空间分辨率低，要么精度差。 Cine-DENSE 以像素空间分辨率高精度地跟踪整个心动周期中的心肌运动。最近已在 cine-DENSE 中实施了切片跟踪，以实现精确的 3D 左心室 (LV) 运动跟踪。这些方法尚未应用于 RV，并且尚未实现 LV 和 RV 心肌的自动分割。 Cine-DENSE 尚未应用于心肌病中发生的室壁运动异常的研究，并且提供比先前研究中使用的技术更高的空间分辨率。具体而言，室壁运动异常与致心律失常性右心室心肌病 (ARVC) 和围产期心肌病 (PCM) 患者的 1 年结局相关。通过开发更稳健的相位展开算法，将开发用于 LV 和 RV 心肌运动 3D 跟踪的工具；将使用基于运动的算法实现自动心肌分割，并通过结合应变编码 (SENC) 和 DENSE MRI 以像素分辨率计算 3D 心肌内应变张量。

DESCRIPTION (provided by applicant): This research will be conducted primarily in South Africa at the University of Cape Town (UCT) and Groote Schuur Hospital (GSH) in Cape Town, South Africa, in collaboration with Drs Mayosi, Meintjes, and Smedema, as an extension of NIH grant #1 R01 EB001763. The overall aim is to apply cine-DENSE (Displacement Encoding with Stimulated Echos) MRI to the study of wall motion abnormalities that occur in left-and right ventricular forms of cardiomyopathy that are particularly prevalent in sub-Saharan Africa and to develop highly automated algorithms for the quantitative analysis of such images. The cardiomyopathies pose the greatest challenge of all the cardiovascular diseases in Africa because of their greater prevalence in societies still plagued by diseases of famine and pestilence; difficulty in diagnosis due to the lack of specialized cardiological investigations in resource poor environments; the lack of access to effective interventions such as heart transplantation; and the high mortality associated with these often irreversible disorders of heart muscle. Wall motion abnormality in cardiomyopathy may be the earliest functional abnormality before clinically detectable heart failure and may provide direct information about the contractile function of the heart. Previous wall motion imaging techniques suffer from either low spatial resolution or poor accuracy. Cine-DENSE achieves tracking of the myocardial motion through the cardiac cycle at pixel-wise spatial resolution with high accuracy. Slice following has recently been implemented for cine-DENSE achieving accurate 3D left ventricular (LV) motion tracking. These methodologies have not been applied to the RV and automatic segmentation of the LV and RV myocardium has not been achieved. Cine-DENSE has not been applied to the study of wall motion abnormalities that occur in cardiomyopathy and offers higher spatial resolution than techniques used in previous studies. Specifically, wall motion abnormality will be correlated with outcome at 1 year in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and peripartum cardiomyopathy (PCM). Tools will be developed for 3D tracking of the myocardial motion of both the LV and RV by developing a more robust phase unwrapping algorithm; automatic myocardial segmentation will be achieved using a motion-based algorithm, and 3D intramyocardial strain tensors will be computed at a pixel resolution by combining Strain Encoded (SENC) and DENSE MRI.