Advanced MRI methods to image vascular physiology with respiratory manipulations

先进的 MRI 方法通过呼吸操作对血管生理学进行成像

• 批准号: 9221375
• 负责人: Hanzhang Lu
• 金额: $ 24.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9221375
• 关键词: Acetazolamide; Allergic; Bicarbonates; Blood; Blood Vessels; Bolus Infusion; Brain; Brain Diseases; Brain Neoplasms; Brain imaging; Breathing; Carbon Dioxide; Caring; Carotid Stenosis; Categories; Cerebrovascular Circulation; Cerebrovascular system; Clinical; Collection; Contrast Media; Data; Data Set; Diamox; Gadolinium DTPA; Gases; Glomerular Filtration Rate; Goals; Gold; Health; Image; Injection of therapeutic agent; Intracranial Arterial Stenosis; MRI Scans; Magnetic Resonance Imaging; Measurement; Measures; Medical Imaging; Metabolic Pathway; Methods; Microvascular Dysfunction; Moyamoya Disease; Neurophysiology - biologic function; Outcome; Patients; Perfusion; Pharmaceutical Preparations; Physiological; Physiology; Play; Positron-Emission Tomography; Procedures; Property; Radioactive Tracers; Radioisotopes; Radiology Specialty; Reading; Residual state; Rest; Role; Scanning; Scheme; Signal Transduction; Stream; Stress Tests; Stroke; Techniques; Technology; Time; Traumatic Brain Injury; Validation; Vasodilation; Vasodilator Agents; Visit; Vulnerable Populations; base; biomaterial compatibility; blood oxygenation level dependent response; cerebral blood volume; cerebrovascular; cerebrovascular health; clinical practice; cost; deoxyhemoglobin; hemodynamics; imaging modality; independent component analysis; indexing; nervous system disorder; novel; pediatric patients; perfusion imaging; public health relevance; research study; respiratory; response; single photon emission computed tomography; technique development; time use; tool

 DESCRIPTION (provided by applicant): Vascular imaging of the brain has played an important role in the management of a variety of brain disorders, such as intracranial stenosis, carotid artery stenosis, stroke, small vessel diseases, brain tumor, traumatic brain injury, Moyamoya disease, and drug-addictive conditions. Both baseline examinations and stress tests are commonly used in clinical practice and they provide complementary information. However, a major limitation is that collection of all of this information requires separate scans and, in some cases, separate visits. This limitation increases patient burden and significantly escalates the cost of care. Therefore, the goal of this R21 project is to develop advanced methods to perform a "one-stop-shop" imaging of vascular physiology that provides multiple domains of information. The proposed technique uses the time of a single scan to apply both O2 and CO2 gas inhalation tasks, which provide baseline and vascular reactivity information, respectively, and tracks the gas bolus to obtain transit time information, as well as extracting functional connectivity networks from the same dataset. CO2 and O2 are important components of our body's metabolic pathway, but they also have interesting vascular properties in the context of brain perfusion imaging. CO2 is a potent vasodilator and can be used to measure vascular reactivity. O2 is inert to blood vessels but its inhalation changes BOLD MRI signal, which allows the estimation of an index of baseline cerebral blood volume (CBV). Furthermore, with our novel breathing paradigm, both CO2 and O2 tasks can be completed concomitantly with the duration of one scan. Additionally, inhaled O2 and CO2 can serve as boluses in the blood stream for the measurement of bolus time-to-peak (TTP). Finally, BOLD MRI data acquired during gas-inhalation tasks can be used for the analysis of functional connectivity networks of the brain. Therefore, our central hypothesis is that a single MRI scan with the proposed procedure will simultaneously provide baseline CBV, cerebrovascular reactivity, time-to-peak, and resting-state functional connectivity. We will first conduct development of the technique in healthy controls (in Aim 1), then perform validation and initial clinical demonstration in patients with intracranial arterial stenosis (in Aim 2). Impact: The impact on clinical practice is that cerebrovascular patients who require both baseline and reactivity assessment will be able to complete the whole procedure with just one visit of 10-15 minutes (as opposed to two visits of 90 minutes each). Additionally, patients who are allergic to conventional contrast agent will have access to an alternative contrast agent (i.e. O2 and CO2 gases) for their vascular imaging needs.

 描述（由申请人提供）：脑血管成像在各种脑部疾病的治疗中发挥了重要作用，如颅内狭窄、颈动脉狭窄、卒中、小血管疾病、脑肿瘤、创伤性脑损伤、烟雾病和药物成瘾性疾病。基线检查和压力测试都是临床实践中常用的，它们提供了补充信息。然而，一个主要的限制是，收集所有这些信息需要单独的扫描，并且在某些情况下， 个案分开探访这种限制增加了患者负担，并显著增加了护理成本。因此，该R21项目的目标是开发先进的方法来执行血管生理学的“一站式”成像，提供多个信息领域。 所提出的技术使用单次扫描的时间来应用O2和CO2气体吸入任务，其分别提供基线和血管反应性信息，并跟踪气体团以获得通过时间信息，以及从同一数据集提取功能连接网络。CO2和O2是我们身体代谢途径的重要组成部分，但它们在脑灌注成像的背景下也具有有趣的血管特性。CO2是一种有效的血管扩张剂，可用于测量血管反应性。O2对血管是惰性的，但其吸入改变了BOLD MRI信号，这允许估计基线脑血容量（CBV）的指数。此外，通过我们的新型呼吸模式，CO2和O2任务都可以在一次扫描的持续时间内完成。此外，吸入的O2和CO2可用作血流中的推注，用于测量推注达峰时间（TTP）。最后，在气体吸入任务期间获得的BOLD MRI数据可用于分析大脑的功能连接网络。 因此，我们的中心假设是，采用所提出的程序进行的单次MRI扫描将同时提供基线CBV、脑血管反应性、达峰时间和静息状态功能连接。我们将首先在健康对照组中进行该技术的开发（在 目的1），然后在颅内动脉狭窄患者中进行验证和初步临床证明（目的2）。 影响：对临床实践的影响是，需要进行基线和反应性评估的脑血管患者将能够仅用一次10-15分钟的访视（而不是每次90分钟的两次访视）完成整个程序。此外，对常规造影剂过敏的患者将可以使用替代造影剂（即O2和CO2气体）以满足其血管成像需求。