Development and Early Clinical Evaluation of Noninvasive MRI Measurement of ICP

无创 MRI 测量 ICP 的开发和早期临床评估

• 批准号: 7273745
• 负责人: NOAM ALPERIN
• 金额: $ 31.72万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-08 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7273745
• 关键词: Animal Model; Biomedical Engineering; Blood; Brain; Brain Edema; Cerebellar tonsil; Cerebrovascular Circulation; Clinical; Computer Simulation; Development; Diagnosis; Diagnostic; Disease; Functional disorder; Goals; Individual; Intracranial Pressure; Invasive; Magnetic Resonance Imaging; Measurement; Measures; Methods; Monitor; Neurologic; Numbers; Patients; Play; Radiology Specialty; Reproducibility; Risk; Role; Sampling; Scanning; Scheme; Spinal Canal; Techniques; Testing; Time; Validation; Weight; Work; base; blood flow measurement; brain tissue; cerebrospinal fluid flow; clinically relevant; data acquisition; healthy volunteer; improved; malformation; nervous system disorder; neurosurgery; nonhuman primate; novel; novel diagnostics; pressure; research clinical testing; tool

DESCRIPTION (provided by applicant): This bioengineering-radiology-neurosurgery partnership aims to further develop and test the clinical utility of a novel method for non-invasive measurement of intracranial compliance (ICC) and intracranial pressure (ICP). These important neurophysiologic parameters are measured using dynamic magnetic resonance imaging (MRI) of blood and cerebrospinal fluid (CSF) flows to and from the brain. The feasibility of this new technique is demonstrated using phantoms, computer simulations, non-human primate animal model, healthy volunteers, and small number of patients. Noninvasive quantification of these parameters is potentially important for improved diagnosis and treatment of several neurological problems. In this proposal we aim to demonstrate the potential clinical utility of a noninvasive ICC measurement to study a relatively common and poorly understood neurological problem, Chiari Malformations (CM) (associated with downward displacement of the cerebellar tonsils into the spinal canal). Some evidence suggests that ICC plays an important role in the pathophysiology of this disorder. However, because of increased risk of brain herniation associated with invasive ICC measurements in these patients, intracranial compliance has not been measured previously. Noninvasive ICC measurement in CM may help explain the pathophysiology and will potentially improve the diagnosis and treatment of this debilitating disorder. Moreover, since MRI is already used to diagnose CM, it would be practical to add the additional scan to obtain the ICC measurement noninvasively. While intracranial compliance quantifies the ability of the intracranial compartment to accommodate increase in volume (e.g., brain swelling) without a large increase in pressure, it is ICP that is more widely used clinically. Our MRI-based measurement of ICP relies on the inverse relationship between ICC and ICP. We propose further validations of a strong linear correlation we found between MR-ICP and invasively measured ICP in 9 patients. The proposed validations are an essential step before the method can become clinically acceptable and the potentially high diagnostic value of a noninvasive MR-ICP can be assessed in other neurological problems. The developmental components of the proposal aim at improving the MRI data acquisition scheme and at shortening overall scan time, primarily for increased measurement reliability by multiple sampling of ICP and for allowing dynamic measurements of ICP. The proposed developmental work also aims to improve measurements of total cerebral blood flow (tCBF), a byproduct of the MR-ICP measurement, by normalizing for the subject's total brain tissues volumes and weights. Preliminary results demonstrated lesser inter-individual variability of the normalized tCBF measurement.

描述（由申请人提供）：该生物工程-放射学-神经外科合作伙伴关系旨在进一步开发和测试用于颅内顺应性（ICC）和颅内压（ICP）无创测量的新方法的临床效用。这些重要的神经生理学参数是使用血液和脑脊液（CSF）流入和流出大脑的动态磁共振成像（MRI）测量的。这项新技术的可行性证明使用幻影，计算机模拟，非人灵长类动物模型，健康志愿者，和少量的患者。这些参数的非侵入性量化对于改善几种神经问题的诊断和治疗具有潜在的重要性。在这个建议中，我们的目的是证明潜在的临床实用性的非侵入性ICC测量研究一个相对常见的和知之甚少的神经系统问题，基亚里畸形（CM）（与向下位移的小脑扁桃体进入椎管）。一些证据表明，ICC在这种疾病的病理生理学中起着重要作用。然而，由于在这些患者中与侵入性ICC测量相关的脑疝风险增加，因此先前未测量颅内顺应性。无创ICC测量CM可能有助于解释的病理生理学，并将有可能提高这种衰弱性疾病的诊断和治疗。此外，由于MRI已经用于诊断CM，因此增加额外的扫描以非侵入性地获得ICC测量将是实际的。虽然颅内顺应性量化了颅内隔室适应体积增加的能力（例如，脑肿胀）而不增加大量的压力，它是ICP，临床上使用更广泛。我们基于MRI的ICP测量依赖于ICC和ICP之间的反比关系。我们建议进一步验证我们在9例患者中发现的MR-ICP和侵入性测量的ICP之间的强线性相关性。在该方法成为临床可接受的方法之前，拟议的验证是一个重要的步骤，并且可以在其他神经系统问题中评估无创MR-ICP的潜在高诊断价值。该提案的开发部分旨在改进MRI数据采集方案并缩短总体扫描时间，主要是为了通过ICP的多次采样提高测量可靠性，并允许ICP的动态测量。拟议的开发工作还旨在通过对受试者的总脑组织体积和重量进行标准化来改善总脑血流量（tCBF）的测量，这是MR-ICP测量的副产品。初步结果表明，归一化tCBF测量的个体间变异性较小。