Quantitative ASL MR angiography and perfusion imaging for cerebral revascularization

项目摘要/摘要 脑血管疾病是世界范围内导致死亡和残疾的主要原因之一。大脑 血管重建术，尤其是外科血管重建术，已经发展成为一种有效的外科治疗方法。 慢性脑血管疾病的治疗，如烟雾病、复杂动脉瘤和 选择颈动脉狭窄闭塞症改善脑血流动力学，降低卒中风险。 尽管如此，最佳的手术计划仍然不清楚，因为各种血运重建技术可能是 考虑过了。到目前为止，血管重建策略的选择主要是基于主观的解释 面临风险的地区的流动需求。这导致了一种可变的、主观的临床实践，将患者 有发生血流动力学相关术后并发症的风险，严重影响临床结果。一个 脑血管重建前后脑血流动力学的节段性定量表征 有必要对象化流程要求，标准化和改善病人护理。然而，现有的 临床成像方式能够提供高时空分辨率的血管成像 不含造影剂的单个动脉节段的定量血流动力学信息。大动脉旋转 标记(Asl)具有吸引人的特征，允许同时评估灌注和血管造影术。 从数量上讲。基于我们在ASL 4D MRA和ASL开发方面的成功记录 本项目的目标是开发和评估一种易于携带的非侵入性ASL。 由先进的4D磁共振血管成像和脑灌注地形图组成的套件可定量评估大脑 脑血管重建术前后单个动脉和下游组织的血流动力学。在AIM 1、我们将开发和优化一种新的快速高时空分辨率的4D MRA技术(&lt；5分钟)。在……里面 AIM2，我们将开发和验证脑血流动力学量化的后处理算法和 血管区域的4D MRA和随机血管编码的ASL。通过利用来自 南加州大学血管重建中心，在目标3中，我们将定量评估围术期的血流动力学 接受脑血管重建术的患者及其与血管重建术的相关性研究 血流动力学变化与临床结局的关系。该项目的成功完成将带来一个强大的， 10分钟扫描时间内的非侵入性、灵活和定量的ASL MRI套件，可随时整合 进入临床核磁共振成像环境。建议的技术可以作为一种潜在的成像工具用于 脑血管重建中血流需求的定量评估。

PROJECT SUMMARY/ABSTRACT Cerebrovascular disease is one of the leading causes of death and disability worldwide. Cerebral revascularization, especially surgical revascularization, has evolved as an effective surgical therapy for the management of chronic cerebrovascular diseases such as moyamoya disease, complex aneurysms, and selected carotid steno-occlusive disease to improve the cerebral hemodynamics and reduce the risk of stroke. Nonetheless, optimal surgical planning is still unclear as a variety of revascularization techniques can be considered. To date, the choice of revascularization strategy is primarily based on the subjective interpretation of flow demands in the at-risk territory. This results in a variable, subjective clinical practice that places patients at risk for hemodynamics-related postoperative complications, significantly impacting the clinical outcomes. A segmented and quantitative characterization of cerebral hemodynamics pre- and post-revascularization is necessary to objectify flow requirements, standardize and improve patient care. However, none of the existing clinical imaging modalities are able to provide high spatiotemporal resolution angiographic images with quantitative hemodynamic information from individual arterial segments without contrast agents. Arterial spin labeling (ASL) possesses appealing features that allow for the assessment of both perfusion and angiography quantitatively. Building upon our successful track record on the development of ASL 4D MRA as well as ASL perfusion imaging, the goal of the present project is to develop and evaluate an easily-carry-out noninvasive ASL suite consisting of advanced 4D MRA and perfusion territorial mapping to quantitively assess cerebral hemodynamics from individual arteries and downstream tissue pre and post-cerebral revascularization. In Aim 1, we will develop and optimize a novel rapid high spatiotemporal resolution 4D MRA technique (<5minutes). In Aim2, we will develop and validate post-processing algorithms for cerebral hemodynamic quantification and vascular territories with 4D MRA and random vessel-encoded ASL. By leveraging the rich clinical resource from the USC Revascularization Center, in Aim 3, we will quantitively evaluate perioperative hemodynamics on patients who undergo cerebral revascularization and study the association of revascularization-related hemodynamic change with clinical outcomes. The successful completion of this project will lead to a robust, noninvasive, flexible, and quantitative ASL MRI suite within 10 min scan time that is ready to be incorporated into clinical MRI settings. The proposed technique can be highly valuable as a potential imaging tool for the quantitative evaluation of flow demands in cerebral revascularization.