Improved imaging of carotid plaque using high-resolution, motion-corrected 3D MRI

 描述(由申请人提供)：我们在这个项目中的目标是克服主要障碍，阻止MRI成为颈动脉疾病评估的临床标准。颈动脉MRI的独特之处在于，除了临床上与直径狭窄百分比相关的测量外，它还有可能准确测量易受攻击的斑块标志物。除了颈动脉狭窄，在研究环境中使用MRI的研究发现，颈动脉斑块内炎症(IPI)、斑块内出血(IPH)、坏死核(NC)、纤维帽(FC)厚度和破裂是重要的中风危险因素。尽管MRI具有测量这些因素的潜力，但在临床环境中使用颈动脉MRI仍然存在主要障碍。这些问题包括1)所有患者都缺乏针对颈动脉分叉解剖位置的线圈，以及2)缺乏高分辨率MRI序列来准确测量呼吸、心脏和吞咽运动时的管腔、狭窄和斑块成分。在这个项目中，我们将：1)开发一种新型的颈动脉成像线圈，其上的模块可互换阵列与患者颈部解剖的范围相匹配；2)开发创新的脉冲序列，以精确测量颈动脉腔、狭窄和斑块组件；3)开发脉冲序列方法和重建算法，以检测和纠正运动损坏的测量；以及4)通过与组织学的比较来验证这些结果。量身定做的贴片射频线圈的开发将提高信噪比，并允许更高的空间和时间分辨率。这种来自模块化线圈的更高的SNR与运动稳健序列相结合，将提高识别体内斑块组件的准确性。这将为未来的研究奠定基础，使用颈动脉MRI来最佳地表征卒中风险，并监测旨在降低IPI、IPH、NC和稳定FC的治疗效果。这些方法方便、一致和准确地描述颈动脉腔和斑块成分，将克服使用MRI作为临床标准来描述颈动脉疾病的主要障碍。这将有助于颈动脉MRI从已经开发出MRI方法的研究环境过渡到普通诊所，在那里将使个体患者受益，并最终降低对社会的成本。

 DESCRIPTION (provided by applicant): Our goal in this project is to overcome major barriers preventing MRI from being the clinical standard for carotid disease evaluation. Carotid MRI is unique in that it has the potential to accurately measure vulnerable plaque markers in addition to the clinically relevant measurement of percent diameter stenosis. In addition to carotid stenosis, studies using MRI in the research setting have found that carotid intraplaque inflammation (IPI), intraplaque hemorrhage (IPH), necrotic core (NC), and fibrous cap (FC) thickness and disruption are important stroke risk factors. Although MRI has the potential to measure these factors, major barriers still exist to using carotid MRI in the clinical setting. These include 1) he lack of a coil specific to the anatomic location of the carotid bifurcation in all patients and 2) he lack of high-resolution MRI sequences to accurately measure lumen, stenosis, and plaque components in the presence of respiratory, cardiac, and swallowing motion. In this project we will: 1) develop a novel carotid imaging coil with modular interchangeable arrays on formers that match the range of patient neck anatomy encountered; 2) develop innovative pulse sequences to accurately measure carotid lumen, stenosis and plaque components; 3) develop pulse sequence methods and reconstruction algorithms to detect and correct motion-corrupted measurements; and 4) validate these results by comparison with histology. The development of tailor-made subject fitting RF coils will increase SNR and allow higher spatial and temporal resolution. This increased SNR from the modular coils coupled with motion- robust sequences will increase accuracy of identifying in-vivo plaque components. This will lay the foundation for future studies using carotid MRI to optimally characterize stroke risk and monitor treatment effects geared toward decreasing IPI, IPH, NC, and stabilizing the FC. These methods that conveniently, consistently, and accurately depict carotid lumen and plaque components will overcome the major barriers to the use of MRI as the clinical standard in characterizing carotid disease. This will facilitate the transition of carotid MRI from the research setting where MRI methods have been developed to the general clinic where benefit to the individual patient will be obtained and costs to society will ultimately be reduced.