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

描述（由申请人提供）：本研究将主要在南非开普敦大学（UCT）和南非开普敦的Groote Schuur医院（GSH）进行，与Mayosi， Meintjes和Smedema博士合作，作为NIH资助#1 R01 EB001763的延伸。总体目标是应用电影密集（位移编码与刺激回声）MRI来研究在撒哈拉以南非洲特别普遍的左心室和右心室形式的心肌病中发生的壁运动异常，并开发高度自动化的算法来定量分析这些图像。在非洲，心肌病是所有心血管疾病中最大的挑战，因为它们在仍受饥荒和瘟疫困扰的社会中更为普遍；在资源贫乏的环境中，由于缺乏专门的心脏病调查而导致诊断困难；缺乏获得心脏移植等有效干预措施的机会；高死亡率与这些不可逆的心肌疾病有关。心肌病的壁运动异常可能是临床上可检测到的心力衰竭之前最早的功能异常，可以提供心脏收缩功能的直接信息。以前的墙体运动成像技术要么空间分辨率低，要么精度差。Cine-DENSE通过心脏周期以像素级空间分辨率实现心肌运动的高精度跟踪。切片跟踪最近实现了cine-DENSE实现精确的3D左心室（LV）运动跟踪。这些方法尚未应用于左心室，左心室和右心室心肌的自动分割尚未实现。Cine-DENSE尚未应用于心肌病中发生的壁运动异常的研究，并且比先前研究中使用的技术提供更高的空间分辨率。具体而言，对于心律失常性右室心肌病（ARVC）和围产期心肌病（PCM）患者，壁运动异常将与1年预后相关。通过开发更强大的相位展开算法，将开发用于左室和右室心肌运动3D跟踪的工具；使用基于运动的算法实现自动心肌分割，并结合应变编码（应变编码，SENC）和DENSE MRI以像素分辨率计算三维心内应变张量。

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.