Improved Measurement of Celebral Perfusion with MRI

该项目的长期目标是改善对缺血性脑血管疾病的诊断和治疗。 中风患者。 在工业化世界中，缺血性中风是导致死亡和残疾的第三大原因。在美国 仅每年就有50万到75万人受到中风的影响。在缺血性中风中， 血液凝块阻塞了供大脑的血管。急性缺血性中风可通过药物治疗 溶解血栓的疗法(溶栓)。溶栓已被证明可以减少死亡和 残疾与中风有关，但具有破坏性脑出血(ICH)的重大风险， 这表明有必要进行仔细的分类。如果没有预测脑出血的手段，溶栓就必须被否定为结束 90%的中风患者。有证据表明，以毫升/分钟为单位计算脑血流量有助于预测脑出血。 急性中风患者。治疗缺血性中风的一个主要障碍是缺乏广泛的 可用于量化分类的CBF的方法！这促使美国人的心脏和中风 协会建议：“必须进行更多的研究，以使这些技术，特别是 基于MR的方法，可量化。我们最近开发了一种新的MRI脉冲序列，用于 我们将在缺血性卒中的动物模型和 急慢性脑缺血患者。我们将证明qCBF可用于对患者进行风险分层，因此 正常情况下不符合溶栓条件的患者可以通过这种救命药物得到安全的治疗 心理治疗。这项提议的具体目的是检验以下假设： 具体目的1：MRI血流灌注测量可以准确定量正常犬的脑血流量。 具体目标2：磁共振血流灌注测量可以准确地量化犬脑缺血模型的脑血流量 卒中。 具体目的3：MRI测量可预测慢性脑缺血患者的脑血流量。 具体目标4：在急性中风患者中，定量CBF值可以预测颅内出血 由溶栓引起的。 在这项工作成功完成后，我们将开发并验证一种新的核磁共振方法 这量化了CBF对急性中风患者的分诊。

The broad, long-term objective of this project is to improve the diagnosis and treatment of ischemic stroke patients. Ischemic stroke is the third leading cause of death and disability in the industrialized world. In the US alone, between 500,000 and 750,000 people are affected by stroke each year. In an ischemic stroke, a blood clot blocks a blood vessel feeding the brain. Acute ischemic stroke is treatable through the use of drug therapies that dissolve blood clots (thrombolysis). Thrombolysis has been shown to reduce the death and disability associated with stroke, but carries significant risk of devastating intracerebral hemorrhage (ICH), indicating the need for careful triage. Without a means to predict ICH,thrombolysis must be denied to over 90% of stroke patients. Evidence has shown that knowledge of CBF in ml/1 OOg-min can help predict ICH in acute stroke patients. A major impediment in treatment of ischemic stroke is the lack of a widely available method for quantifying CBFfor triage! This has prompted the American Heart and Stroke Association to recommend: "More research must be conducted to make these techniques, especially the MR-based methods, quantifiable". We have recently developed a novel MRI pulse sequence for quantitative CBF.We will validate this diagnostic technique in both animal models of ischemic stoke and in a patients with acute and chronic ischemia. We will show that qCBF can be used to risk stratify patients so that patients who would not normally be eligible for thrombolysis can be safely treated with this lifesaving therapy. The specific aims of this proposal are to test the following hypotheses: Specific Aim 1: MRI measurements of perfusion can accurately quantify CBF in normal canines. Specific Aim 2: MRI measurements of perfusion can accurately quantify CBF a canine model of ischemic stroke. Specific Aim 3: MRI measurements can predict CBF in chronic ischemic patients. Specific Aim 4: In acute stroke patients, quantitative CBF values can predict intracranial hemorrhage resulting from thrombolysis. Upon successful completion of this work we will have developed and validated a new MRImethod that quantifies CBFfor the triage of acute stroke patients.