Functional Cardiovascular 4D MRI in Congenital Heart Disease

先天性心脏病中的功能性心血管 4D MRI

• 批准号: 8534282
• 负责人: Michael Markl
• 金额: $ 35万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8534282
• 关键词: 3 year old; 8 year old; Adult; Affect; Anatomy; Aorta; Aortic Valve Insufficiency; Bicuspid; Biological Markers; Blood Vessels; Blood flow; Breathing; Caliber; Cardiac; Cardiovascular Physiology; Cardiovascular system; Catheterization; Catheters; Cessation of life; Chest; Child; Childhood; Clinical; Cognitive; Common Ventricle; Complex; Congenital Abnormality; Data; Data Analyses; Diagnostic; Diagnostic tests; Dilatation - action; Disease; Disease Outcome; Disease Progression; Epidemiologist; Evaluation; Exposure to; Functional Magnetic Resonance Imaging; General Anesthesia; Goals; Heart; Image; Imaging Techniques; Ionizing radiation; Knowledge; Life; Link; Live Birth; Longitudinal Studies; Magnetic Resonance Imaging; Maps; Measurement; Measures; Methods; Monitor; Morphology; Neurologic; Operative Surgical Procedures; Outcome; Outcome Measure; Patients; Pattern; Physiology; Pilot Projects; Plant Roots; Population; Postoperative Period; Procedures; Prognostic Marker; Protocols documentation; Risk; Risk Assessment; Scanning; Sedation procedure; Social Development; Stenosis; Surveys; Techniques; Testing; United States; Validation; Vascular remodeling; age group; aortic valve; arm; ascending aorta; base; clinical practice; cohort; congenital heart disorder; follow-up; hemodynamics; improved; in vivo; neonate; novel; novel diagnostics; pressure; repaired; shear stress; time use; tool; two-dimensional; young adult

DESCRIPTION (provided by applicant): Congenital heart disease (CHD) represents the most common birth defect and affects approximately 1.2% of all live births and is the leading cause of birth defect-related deaths. CHD patients require frequent diagnostic testing in order to plan surgical repair, assess preoperative risk, and/or survey for important long-term complications. Bicuspid aortic valve (BAV), one of the most common forms of CHD, and single ventricle physiology (SVP), one of the most severe, are two patient cohorts which will require such longitudinal surveillance. Standard diagnostic tools, however, often involve invasive catheter-based procedures, ionizing radiation, and/or lengthy 60-90 minute Magnetic Resonance Imaging (MRI) exams, necessitating sedation or general anesthesia in pediatric patients. Recent studies suggest that general anesthesia could adversely affect neurologic, cognitive, and social development of neonates and young children. In addition, common outcome measures for CHD diseases such as BAV or SVP are coarse and rely on simplified parameters such as the diameter of the aortic root or the post-operative clinical status which do not reflect the underlyig mechanisms of disease progression. Further knowledge of which BAV and SVP patients are at risk for aortopathy or failing Fontan physiology would improve patient management and therapy planning by defining regular follow-up intervals and generating precise criteria for referral to surgical correction. Our goal is to develop and a new comprehensive 20-minute cardiovascular functional 4D MR exam that can replace the long standard MR imaging protocol and reduce or eliminate exposure to general anesthesia. Patient-specific post-hoc analysis will allow retrospective quantification of cardiac function and flow without limitation to predefined 2D scan planes. In addition, new hemodynamic biomarkers will be derived and evaluated for their potential as prognostic markers for improved outcome prediction in patients with BAV and SVP.

描述(申请人提供)：先天性心脏病(CHD)是最常见的出生缺陷，约占所有活产婴儿的1.2%，是与出生缺陷相关的死亡的主要原因。冠心病患者需要频繁的诊断性测试，以计划手术修复，评估术前风险，和/或调查重要的长期并发症。二尖瓣主动脉瓣(BAV)是最常见的CHD形式之一，单心室生理学(SVP)是最严重的形式之一，是需要进行这种纵向监测的两个患者队列。然而，标准的诊断工具通常包括基于导管的侵入性程序、电离辐射和/或冗长的60-90分钟磁共振成像(MRI)检查，需要对儿科患者进行镇静或全身麻醉。最近的研究表明，全身麻醉可能会对新生儿和幼儿的神经、认知和社会发育产生不利影响。此外，常见的CHD疾病，如BAV或SVP的结果测量方法粗略，依赖于简化的参数，如主动脉根部直径或术后临床状态，这些参数不能反映疾病进展的潜在机制。进一步了解哪些BAV和SVP患者有患大动脉病变或Fontan生理学失败的风险，将通过定义定期随访间隔和生成转诊至手术矫正的准确标准来改进患者管理和治疗计划。我们的目标是开发一种新的全面的20分钟心血管功能4D磁共振检查，可以取代长时间的标准磁共振成像方案，减少或消除全身麻醉的暴露。特定于患者的事后分析将允许对心脏功能和血流进行回顾性量化，而不限于预定义的2D扫描平面。此外，还将衍生和评估新的血流动力学生物标记物作为改善BAV和SVP患者预后预测的潜在预后标记物。