REPERFUSION THERAPY IN STROKE CANDIDATES USING MR PERFUSION & DIFFUSION IMAGING

使用 MR 灌注对中风患者进行再灌注治疗

• 批准号: 7420416
• 负责人: ARGYE HILLIS
• 金额: $ 3.74万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7420416
• 关键词: brain; diffusion; perfusion; reperfusion; stroke; white matter

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The overall goal of Dr. Hillis's research is to identify impairments of specific cognitive processes in hyperacute stroke that predict concurrent dysfunction of specific brain regions and that will be potentially useful in guiding and evaluating acute stroke intervention. The assumption underlying this research is that any given behavioral task (e.g., naming a picture) entails a number of component cognitive processes that are each subserved by relatively focal areas within a network of brain regions responsible for carrying out the task. Thus, dysfunction of any of the relevant focal brain regions may result in disruption of selective components of the task. As such, several developments in TRD1, TRD2 and TRD3 are of importance for Dr. Hillis' research. These are the development of absolute flow measurements using arterial spin tagging and the use of T2* for studying oxygen extraction ratios in TRD1. The development of fast MRSI technology should allow the use of MRSI durin g the hyperacute phase of stroke, which is now prohibited due to the restricted treatment window. The proposed research in TRD3 and 4 is important for stroke rehabilitation in the more chronic phase of stroke (Days 3 and 90), when reperfusion treatment is no longer an option under present guidelines. The technology developments in TRD3 should allow the detection of relationships between impaired cognitive skills and remote regions suffering from stroke through the imaging of the connecting fibers and the evaluation of these fiber properties. The development of dynamic fiber tracking in TRD4 aids both TRD3 and Dr. Hillis' research. In addition to this, it is our intention to include fMRI in this evaluation of more chronic patients, which would benefit from most of the developments in TRD1 and TRD4 related to fMRI improvements. TRD 3 has been very active: For patients who suffer from stroke, it is very important to know the prognosis and to properly prescribe rehabilitation. Characterization of the location and size of primary stroke lesions by MRI is one of the most important steps toward this goal. Conventional T2-weighted MR images can delineate gray and white matter regions that are involved in the stroke. The gray and white matter consists of various areas with different functionalities, which cannot be differentiated by conventional MRI. Because there is accumulated knowledge about the relationship between gray matter areas and brain functions, it is possible to deduce impacts of stroke lesions on the gray matter and related brain functions from the locations of the stroke observed by MRI. However, such a location-function relationship has not been well established in the white matter. Furthermore, the conventional MRI cannot differentiate various functional units (white matter tracts) in the white matt er. Diffusion tensor imaging (DTI) is a technique that can identify and assess the status of individual white matter tracts. Our hypothesis is that the DTI provides detailed neuroanatomy of brain white matter, which will be crucial information for prognosis and prescription of rehabilitation. In this grant year, we focused on setting up DTI imaging protocols using a group of healthy volunteers (n = 10) and one stroke patient. The results indicated that the technique could delineate specific degeneration of white matter tracts.

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。希利斯博士研究的总体目标是找出超急性中风患者特定认知过程的损害，这些损害可以预测特定脑区同时出现的功能障碍，这可能有助于指导和评估急性卒中干预。这项研究的基本假设是，任何给定的行为任务(例如，命名一幅画)都需要一些组成部分的认知过程，每个过程都由负责执行任务的大脑区域网络中相对集中的区域辅助。因此，任何相关的大脑局部区域的功能障碍都可能导致任务的选择性成分中断。因此，TRD1、TRD2和TRD3的几个发展对希利斯博士的研究具有重要意义。这些是使用动脉自旋标记的绝对流量测量的发展，以及使用T2*来研究TRD1中的氧提取比率。快速MRSI技术的发展应该允许在卒中超急性期使用MRSI，目前由于治疗窗口的限制，这一阶段被禁止。在TRD3和4中建议的研究对于中风更慢性阶段(第3天和第90天)的中风康复很重要，因为在目前的指南下，再灌注治疗不再是一种选择。TRD3的技术发展应该能够通过对连接纤维的成像和这些纤维特性的评估来检测认知技能受损和中风偏远地区之间的关系。TRD4中动态纤维跟踪的发展为TRD3和Hillis博士的研究提供了帮助。除此之外，我们打算将功能磁共振纳入对更多慢性患者的评估中，这将受益于TRD1和TRD4中与功能MRI改善相关的大多数发展。TRD3一直非常活跃：对于中风患者来说，了解预后并适当开出康复处方是非常重要的。通过MRI确定原发性卒中病变的位置和大小是迈向这一目标的最重要的步骤之一。常规的T2加权磁共振图像可以勾画出与中风有关的灰质和白质区域。灰质和白质由不同的区域组成，具有不同的功能，常规MRI无法区分。由于已经积累了关于灰质区和脑功能之间关系的知识，所以有可能从MRI观察到的中风部位推断中风病变对灰质和相关脑功能的影响。然而，这种位置-功能关系在白质中还没有很好地建立起来。此外，常规MRI不能区分白质中的各种功能单位(白质束)。弥散张量成像(DTI)是一种可以识别和评估单个白质束状态的技术。我们的假设是，DTI提供了脑白质的详细神经解剖，这将是预后和康复处方的关键信息。在这一捐赠年，我们专注于使用一组健康志愿者(n=10)和一名中风患者建立DTI成像方案。结果表明，该技术可显示脑白质束的特异性变性。