Rapid Real-Time Cardiovascular MRI for Detecting Coronary Artery Disease
用于检测冠状动脉疾病的快速实时心血管 MRI
基本信息
- 批准号:9753768
- 负责人:
- 金额:$ 37.62万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-09-01 至 2022-08-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAgreementAlgorithmsAngiographyArrhythmiaBasic ScienceBreathingCardiacCardiac Catheterization ProceduresCardiovascular systemCathetersCessation of lifeCicatrixClinicalClinical ResearchClinical ServicesClinical TrialsCoronaryCoronary AngiographyCoronary ArteriosclerosisCoronary StenosisDataDevelopmentDiagnosisDiagnosticDiagnostic ImagingDiagnostic testsDigital Imaging and Communications in MedicineEvaluationExposure toFibrosisFinancial HardshipGoalsGoldGuidelinesHeart DiseasesImageImaging TechniquesImaging technologyInferiorIonizing radiationMRI ScansMagnetic Resonance AngiographyMagnetic Resonance ImagingMedical ImagingMethodsModalityMotionMyocardial perfusionNuclearPatientsPerformancePerfusionPhysiologic pulsePlayPopulation HeterogeneityPositron-Emission TomographyProtocols documentationRadialRadiationRadiation Dose UnitResearchResourcesRiskRoentgen RaysRoleSamplingScanningSiteStressStress EchocardiographySurveysTechnologyTestingTimeUniversitiesX-Ray Computed Tomographyaccurate diagnosisbasecardiovascular imagingcoronary computed tomography angiographycost effectivedesigndiagnostic accuracyevaluation/testingexperienceheart functionheart imagingimaging modalityinnovationoperationperfusion imagingradiation riskreconstructionsatisfactionsingle photon emission computed tomographysuccess
项目摘要
Project Summary/Abstract: Coronary artery disease (CAD) is a leading cause of sickness and death in the
US. Noninvasive cardiac imaging plays a vital role in diagnosing, risk stratifying, and guiding treatment
decisions in patients with known or suspected CAD. However, the limitations of current imaging strategies are
well documented. In a previous study of nearly 400,000 patients without known heart disease undergoing
elective cardiac catheterization following a positive pre-test (mostly stress echocardiography and nuclear
perfusion imaging), approximately 60% of them were found to not have obstructive CAD. According to recent
AHA guidelines, radiation risk is an important consideration when choosing a diagnostic test. Indeed, there is
an unmet clinical need to advance radiation-free diagnostic imaging tests for accurate diagnosis of functionally
significant obstructive CAD.
Since no single test is 100% accurate, one cost-effective approach to increase accuracy is to perform a
comprehensive assessment within a single modality. Among available cardiac imaging modalities, MRI is
arguably the most versatile and capable of a comprehensive evaluation of CAD, including cardiac function,
perfusion, coronary angiography, and viability, while not requiring ionizing radiation. Despite substantial
successes from both basic research and clinical trials, and even after decades of advancements, cardiac MRI
continues to be hampered by (i) long exam times (~ 60-90 min), (ii) complexities in operation such as breath-
holding requirements, and (iii) poor performance in patients with arrhythmias. To overcome these obstacles,
we will develop a rapid (15 min), real-time (arrhythmia and motion insensitive) cardiovascular MRI protocol that
can be performed during free breathing, while producing diagnostic accuracy comparable to a standard clinical
MRI protocol (60-90 min).
The central hypothesis of this application is that a rapid (15-min) MRI protocol produces diagnostic accuracy
comparable to a standard clinical MRI protocol. The specific objectives in support of testing our central
hypothesis are: (1) to develop rapid image acquisition and reconstruction methods that will be integrated into a
single protocol streamlined for detecting CAD and (2) to evaluate the agreement between rapid and standard
MRI results. This study leverages extensive clinical and research resources existing at Northwestern University
(~200 cardiac stress MRI scans per year; cardiovascular imaging research). A rapid, free-breathing MRI
protocol is a major step forward in MRI technology, because it will dramatically increase scan efficiency,
simplify scan operation, and reduce financial burdens for imaging centers with limited expertise and resources
to offer cardiovascular MRI as a routine clinical service. Success of this 3-year R01 application will yield
preliminary data needed to pursue a renewal application aimed at validating diagnostic accuracy of a rapid MRI
protocol against catheter X-ray angiography in a diverse population at multiple sites.
项目概要/摘要:冠状动脉疾病(CAD)是美国疾病和死亡的主要原因。
我们无创性心脏成像在诊断、危险分层和指导治疗方面起着至关重要的作用
已知或疑似CAD患者的决策。然而,目前的成像策略的局限性是
有据可查在之前的一项研究中,近40万名没有已知心脏病的患者接受了
在积极的预试验后进行选择性心导管插入术(主要是负荷超声心动图和核
灌注成像),其中约60%被发现没有阻塞性CAD。根据最近的
根据AHA指南,辐射风险是选择诊断测试时的重要考虑因素。确实有
未满足的临床需求是推进无辐射诊断成像测试,以准确诊断功能性
严重梗阻性CAD。
由于没有一个单一的测试是100%准确的,一种提高准确性的经济有效的方法是执行一个
在单一模式下进行全面评估。在可用的心脏成像模式中,MRI是
可以说是最通用的,能够全面评估CAD,包括心脏功能,
灌注、冠状动脉血管造影和活力,而不需要电离辐射。尽管作出了重大的
从基础研究和临床试验的成功,甚至经过几十年的进步,心脏MRI
继续受到以下因素的阻碍:(i)检查时间长(约60-90分钟),(ii)操作复杂性,例如呼吸-
保持要求,和(iii)心律失常患者的不良表现。为了克服这些障碍,
我们将开发一种快速(15分钟)、实时(心律失常和运动不敏感)的心血管MRI方案,
可以在自由呼吸期间进行,同时产生与标准临床诊断相当的诊断准确性。
MRI方案(60-90分钟)。
本申请的中心假设是快速(15分钟)MRI方案可产生诊断准确性
与标准临床MRI方案相当。支持测试我们的中央的具体目标
假设是:(1)开发快速图像采集和重建方法,
简化了检测CAD的单一方案;(2)评价快速和标准之间的一致性
核磁共振结果。这项研究利用了西北大学现有的广泛的临床和研究资源
(每年约200次心脏负荷MRI扫描;心血管成像研究)。快速自由呼吸核磁共振
协议是MRI技术向前迈出的重要一步,因为它将大大提高扫描效率,
简化扫描操作,减少专业知识和资源有限的成像中心的财务负担
提供心血管MRI作为常规临床服务。成功的3年R 01应用将产生
进行旨在验证快速MRI诊断准确性的更新申请所需的初步数据
在多个研究中心的不同人群中进行导管X射线血管造影的方案。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Daniel Kim其他文献
Daniel Kim的其他文献
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{{ truncateString('Daniel Kim', 18)}}的其他基金
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使用全面、快速、自由呼吸的心血管 MRI 定量检测长期新冠肺炎患者的冠状动脉微血管功能障碍
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10327327 - 财政年份:2020
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为心脏植入电子设备患者提供实时宽带心脏 MRI 的多样性补充
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Real-time Wideband Cardiac MRI for Patients with a Cardiac Implantable Electronic Device
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Rapid Pediatric Cardiovascular MRI without Contrast Agent or Anesthesia
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Comparative Assessment of Modifying Social Determinants to Reduce Cardiovascular Disease Burden and Disparities
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