Late Gadolinium Enhancement MRI for Patients with Implantable Cardiac Devices

植入式心脏装置患者的晚期钆增强 MRI

• 批准号: 8723282
• 负责人: Peng Hu
• 金额: $ 22.64万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-19 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8723282
• 关键词: Ablation; Address; Affect; Amyloidosis; Area; Arrhythmogenic Right Ventricular Dysplasia; Artificial cardiac pacemaker; Boxing; Breathing; Cardiac; Cardiac ablation; Cardiomyopathies; Chest; Cicatrix; Clinical; Data; Devices; Diagnosis; Diagnostic; Frequencies; Gadolinium; Gold; Image; Image Enhancement; Imaging Techniques; Implant; Implantable Defibrillators; Left; Location; Magnetic Resonance Imaging; Maps; Measurement; Metals; Methods; Morphologic artifacts; Motion; Myocardial; Myocardial tissue; Myocarditis; Myocardium; Pacemakers; Patients; Pattern; Physiologic pulse; Play; Procedures; Recovery; Recurrence; Reporting; Role; Sarcoidosis; Side; Signal Transduction; Site; Solutions; Techniques; Testing; Time; United States; Validation; Ventricular Tachycardia; base; cohort; design; experience; gadolinium oxide; implantable device; implantation; innovation; novel; public health relevance; reconstruction; research clinical testing; respiratory; success; voltage

DESCRIPTION (provided by applicant): Late gadolinium enhancement (LGE) cardiac MRI plays an important role in diagnosis and treatment of myocardial diseases. It is the clinical "gold standard" in for non-invasive myocardial tissue characterization. Assessment of presence/absence, location, size and pattern of myocardial scar using LGE MRI is often the only non-invasive means of accurately diagnosing and differentiating various forms of non-ischemic cardiomyopathy, including myocarditis, arrhythmogenic right ventricular dysplasia, amyloidosis, and sarcoidosis. LGE MRI also plays an increasing role in guiding catheter ablations, a widely used treatment procedure for ventricular tachycardia (VT) and recurrent ICD therapies. For this procedure, the assessment of myocardial scar location, size and transmurality provided by LGE MRI allows more accurate identification of arrhythmogenic substrate and ablation sites, thereby potentially decreasing procedure time and increasing success rate. Despite the important role of LGE MRI, many of the patients do not undergo cardiac MRI due to prior implantation of cardiac devices. Recent reports suggest that MRI of patients with implanted devices can be performed safely for most patients whose rhythms are not device dependent. The diagnostic value of the LGE images for these patients, however, is often severely limited by significant imaging artifacts that arise from the device generator, a metal box that is implanted predominantly on the left side of the patient's chest. The device generator results in multi-kHz off-resonance within myocardial tissue and typically causes extremely bright signal artifacts, making scar assessment impossible in these affected regions. Herein, we propose hypotheses, technical innovations, and clinical evaluation of a new wideband multi-spectral LGE MRI technique that can be used routinely to significantly reduce LGE imaging artifacts in patients with implanted cardiac devices. Completion of the project will result in the clinical deployment of a set of MRI pulse sequences and reconstruction methods for LGE imaging and successful validation in a cohort of patients with cardiac devices.

描述（由申请人提供）：晚期钆增强（LGE）心脏MRI在心肌疾病的诊断和治疗中起着重要作用。它是临床上的“黄金 用于非侵入性心肌组织定征的标准。使用LGE MRI评估心肌瘢痕的存在/不存在、位置、大小和模式通常是准确诊断和区分各种形式的非缺血性心肌病的唯一非侵入性方法，包括心肌炎、致炎性右心室发育不良、淀粉样变性和结节病。LGE MRI在引导导管消融方面也发挥着越来越大的作用，导管消融是室性心动过速（VT）和复发性ICD治疗的广泛使用的治疗程序。对于该手术，LGE MRI提供的心肌瘢痕位置、大小和透壁性评估允许更准确地识别致瘤基质和消融部位，从而可能缩短手术时间并提高成功率。尽管LGE MRI具有重要作用，但许多患者由于之前植入了心脏器械而未接受心脏MRI。最近的报告表明，对于大多数心律不依赖于器械的患者，可以安全地对植入器械的患者进行MRI。然而，LGE图像对这些患者的诊断价值通常受到器械发生器（主要植入患者胸部左侧的金属盒）产生的显著成像伪影的严重限制。器械发生器导致心肌组织内出现多kHz的非共振，通常会导致极亮信号伪影，从而无法对这些受影响区域进行瘢痕评估。在此，我们提出了一种新的宽带多光谱LGE MRI技术的假设、技术创新和临床评价，该技术可常规用于显著减少植入心脏器械患者的LGE成像伪影。该项目的完成将导致一组MRI脉冲序列和重建方法的临床部署，用于LGE成像，并在心脏器械患者队列中成功验证。

项目成果

Myocardial T1 mapping at 3.0 tesla using an inversion recovery spoiled gradient echo readout and bloch equation simulation with slice profile correction (BLESSPC) T1 estimation algorithm.

• DOI: 10.1002/jmri.24999
• 发表时间: 2016-02
• 期刊: Journal of magnetic resonance imaging : JMRI
• 作者: Shao J;Rapacchi S;Nguyen KL;Hu P
• 通讯作者: Hu P

Device artifact reduction for magnetic resonance imaging of patients with implantable cardioverter-defibrillators and ventricular tachycardia: late gadolinium enhancement correlation with electroanatomic mapping.

• DOI: 10.1016/j.hrthm.2013.10.032
• 发表时间: 2014-02
• 期刊: HEART RHYTHM
• 影响因子: 5.5
• 作者: Stevens, Steven M.;Tung, Roderick;Rashid, Shams;Gima, Jean;Cote, Shelly;Pavez, Geraldine;Khan, Sarah;Ennis, Daniel B.;Finn, J. Paul;Boyle, Noel;Shivkumar, Kalyanam;Hu, Peng
• 通讯作者: Hu, Peng