Development of techniques to map cerebrovascular reactivity with resting-state MRI

开发利用静息态 MRI 绘制脑血管反应性的技术

• 批准号: 9386135
• 负责人: Peiying Liu
• 金额: $ 20.44万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9386135
• 关键词: 20 year old; Acetazolamide; Adverse effects; Blood Vessels; Blood flow; Brain; Breathing; Carbon Dioxide; Cardiac; Caring; Cerebrovascular Disorders; Clinical; Clinical Research; Computers; Core-Binding Factor; Data; Detection; Development; Diagnosis; Diamox; Drops; Electroencephalogram; Event; Frequencies; Functional Magnetic Resonance Imaging; Gases; Goals; Gold; Homeostasis; Image; Injection of therapeutic agent; Intracranial Arterial Stenosis; Ischemia; Location; Logistics; Magnetic Resonance Imaging; Maps; Measurement; Measures; Methods; Microvascular Dysfunction; Monitor; Moyamoya Disease; Nature; Paper; Patients; Pattern; Perfusion; Pharmacology; Photons; Physiologic pulse; Physiological; Procedures; Protocols documentation; Research; Rest; Sampling; Scheme; Signal Transduction; Source; Special Equipment; Stenosis; Stimulus; Stroke; Techniques; Technology; Testing; Time; Variant; Vascular Dementia; Vascular blood supply; Vasodilator Agents; base; brain health; cerebrovascular; clinical Diagnosis; clinical application; clinical practice; cost; early detection biomarkers; hemodynamics; improved; indexing; normal aging; novel; outcome forecast; perfusion imaging; relating to nervous system; research study; technique development; tomography; vasoactive agent

Project Summary/Abstract Diagnosis and treatment monitoring of brain vascular diseases, such as stroke, arterial stenosis, vascular dementia, and small vessel diseases, requires accurate assessment of cerebrovascular parameters. There is substantial evidence that cerebrovascular reactivity (CVR), an index of vascular reserve reflecting the ability of the blood vessels to dilate or constrict, is one of the most sensitive markers for early detection of ischemia. In current clinical settings, CVR measurement requires a vascular challenge during imaging, involving either the injection of pharmacological agent (e.g. acetazolamide), inhalation of CO2 gas, or breath-hold. However, these strategies are not ideal in terms of both patient burden and costs, due to the complexity of the procedure, requirement of special equipment, and possible side-effect of physiological maneuver to induce vascular challenge. Therefore, development of a CVR technique that does not need an explicit vascular challenge will have a significant impact in cerebrovascular diseases. Resting-state BOLD MRI signal manifests spontaneous fluctuations with time. While portions of this signal have been exploited to map functional connectivity of brain networks and have revolutionized the fMRI field, another component of the signal fluctuation is of a vascular origin, due to spontaneous variations in breathing rate and depth that result in time-dependent changes in arterial CO2. This CO2 variation results in a fluctuation in BOLD signal, the amplitude of which is related to CVR. Our preliminary studies have strongly suggested the feasibility of mapping CVR using this CO2 fluctuation, as well as its ability to delineate vascular deficits in patients with intracranial arterial stenosis. Therefore, the central goal of the present study is to expand these preliminary findings and to develop and validate a CVR mapping technique based on MRI data acquired under resting-state, i.e. without gas challenges. First, we will develop acquisition and analysis methods to isolate the CO2 fluctuation component from resting-state BOLD signal for CVR mapping (Study 1 of Aim 1). Potential approaches to augment the sensitivity of the technique will be evaluated (Study 2 of Aim 1). Second, we will conduct simultaneous MRI, electroencephalogram (EEG), and end-tidal CO2 recordings to verify that the signal measured with our method contains minimal neural contribution but predominantly CO2 fluctuation, and validate the proposed CVR mapping technique with the gold-standard CO2-inhalation method (in Aim 2). Finally, we will conduct initial clinical demonstration of this technique in patients with intracranial arterial stenosis (in Aim 3). Impact: The impact on clinical practice is that patients with cerebrovascular diseases, including ones whose are unable to comply with vascular challenges, can receive CVR imaging during a standard MRI session. This will greatly enhance the utility of CVR in clinical diagnosis and prognosis.

项目总结/摘要 脑血管疾病的诊断和治疗监测，如中风、动脉狭窄、血管 痴呆和小血管疾病需要准确评估脑血管参数。有 大量证据表明，脑血管反应性（CVR），一个反映血管储备能力的指标， 血管扩张或收缩，是早期检测缺血最敏感的标志之一。 在当前的临床环境中，CVR测量需要在成像期间进行血管挑战，包括 注射药剂（例如乙酰唑胺）、吸入CO2气体或屏气。 然而，这些策略在患者负担和成本方面都不是理想的，这是由于治疗的复杂性。 程序、特殊设备的要求以及生理操作可能产生的副作用， 血管挑战。因此，开发不需要明确血管的CVR技术， 挑战将对脑血管疾病产生重大影响。 静息状态BOLD MRI信号表现出随时间的自发波动。虽然这个信号的一部分 已经被用来绘制大脑网络的功能连接，并彻底改变了功能磁共振成像领域， 信号波动的另一个分量是由于呼吸中的自发变化引起的血管源 导致动脉CO2随时间变化的速率和深度。这种二氧化碳的变化导致了 在BOLD信号中，其幅度与CVR有关。我们的初步研究强烈表明， 使用这种CO2波动绘制CVR的可行性，以及其描绘血管缺陷的能力， 颅内动脉狭窄患者。 因此，本研究的中心目标是扩大这些初步研究结果， 基于静息状态下（即无气体）采集的MRI数据确认CVR标测技术 挑战首先，我们将开发获取和分析方法，以分离CO2波动分量 来自静息状态BOLD信号，用于CVR标测（目标1的研究1）。可能采取的办法 将评估该技术的灵敏度（目标1的研究2）。第二，我们将同时进行核磁共振成像， 脑电图（EEG）和潮气末CO2记录，以验证用我们的方法测量的信号 包含最小的神经贡献，但主要是CO2波动，并验证建议的CVR 采用金标准CO2吸入法的绘图技术（目标2）。最后，我们将进行初步的 该技术在颅内动脉狭窄患者中的临床证明（目标3）。 影响：对临床实践的影响是，脑血管疾病患者，包括 无法接受血管挑战的患者，可以在标准MRI期间接受CVR成像 上网时段这将大大提高CVR在临床诊断和预后方面的实用性。