3T Atherosclerotic MRI and Carotid Artery Scoring System

描述（由申请人提供）：根据美国国家卫生统计中心的数据，心血管疾病是美国死亡的主要原因。超过70%的死亡与动脉粥样硬化有关，动脉粥样硬化性脑血管疾病是成人死亡和主要残疾的主要原因。起源于颈动脉分叉区域的血栓事件是中风的主要原因。目前，美国每年进行约140，000例颈动脉内膜切除术（CEA）手术以预防这些事件。华盛顿大学血管成像实验室（VIL）将开发一种非侵入性、低成本的替代方法。我们的研究目的是开发这样一种非侵入性成像工具，可以识别和表征颈动脉粥样硬化斑块的特征，这些斑块是即将发生的快速病变进展和缺血性并发症的信号。具体目标是：1.优化MRI技术，用于在3 T上探测动脉粥样硬化颈动脉的管腔表面状况和组织成分。2.开发一个基于MRI的颈动脉评分（CAS）系统，该系统基于管腔和管腔表面条件。3.优化CAS系统中应用于各种照明特性的权重。4.在一项前瞻性研究中，检测CAS预测入选动脉粥样硬化患者的进展或缺血事件。我们将检验这一假设，即动脉瘤特征是颈动脉斑块进展和破裂脆弱性的主要决定因素。MRI成像结合非侵入性体内组织学将提供斑块形态和组织成分的准确信息，特别是在血管壁和管腔的边界处。识别高危斑块的改进方法将导致：1）更好地选择患者进行干预; 2）开发一种准确，可重复和定量的技术，用于直接评估动脉粥样硬化病变的状态和进展，显着降低临床试验的成本; 3）一个独特的机会来检查从稳定病变到易损斑块的进展过程。

DESCRIPTION (provided by applicant): According to the National Center for Health Statistics, cardiovascular disease is the leading cause of death in the U.S. Over 70% of these deaths are related to atherosclerosis, and atherosclerotic cerebrovascular disease is a leading cause of death and major disability among adults. Thrombolic events originating in the bifurcation region of the carotid artery are a major cause of stroke. Currently some 140,000 carotid endarterectomy (CEA) surgeries are performed annually in the U.S. to prevent these events. A non-invasive, lower-cost alternative will be developed at University of Washington's Vascular Imaging Lab (VIL). The purpose of our research is to develop such a non-invasive imaging tool that can identify and characterize the features of carotid atherosclerotic plaque that signal imminent rapid lesion progression and ischemic complications. The specific aims are to: 1. Optimize MRI techniques for probing the luminal surface conditions and tissue composition of atherosclerotic carotid arteries on 3T. 2. Develop an MRI- based carotid artery scoring (CAS) system based on luminal and juxtaluminal surface conditions. 3. Optimize the weightings applied to various juxtaluminal characteristics in the CAS system. 4. Test the CAS for predicting progression or ischemic events within enrolled atherosclerotic patients in a prospective study. We will test the hypothesis that juxtaluminal characteristics are the primary determinants of carotid plaque progression and vulnerability to rupture. MRI imaging in combination with non-invasive in vivo histology will provide accurate information on plaque morphology and tissue composition, especially at the boundaries of the vessel wall and lumen. Improved methods of identifying high-risk plaques will result in: 1) better selection of patients for intervention; 2) development of an accurate, reproducible, and quantitative technique for directly assessing the status and progression of atherosclerotic lesions, significantly reducing the cost of clinical trials; 3) a unique opportunity to examine the processes involved in the progression from a stable lesion to vulnerable plaque.