Cerebrovascular Physiology of Infants with CHD

描述（由申请人提供）：该职业发展奖将支持Daniel light博士成长为儿科脑血管损伤专业的独立临床研究者。Licht博士的主要职业发展目标是建立一个涵盖神经病学、重症监护和神经影像学领域的多学科研究项目。为了实现这些目标，Licht博士建议物理学家和临床医生合作开发新的非侵入性方法来测量新生儿的脑血流量（CBF）。本研究拟通过对新成像技术的改进和应用，探讨脑血流在重度先天性心脏缺陷（CHD）婴儿获得性脑损伤中的作用。脑血流是了解、诊断和处理新生儿脑部疾病的重要生理参数，在重症冠心病患儿心脏手术前脑损伤中起关键作用。在之前的研究中，Licht博士发现，脑血管生理紊乱与术前结构性脑损伤有关。为了进一步研究这种关联，他建议测量和比较冠心病婴儿与非冠心病婴儿的整体和区域脑容量，并确定这些差异是否与CBF改变有关。莱特博士将使用基于核磁共振成像的技术进行这些测量，并将测试漫射光学断层扫描（DOT）进行比较测量。迄今为止，由于缺乏合适的CBF测量技术，儿童脑灌注的规范和疾病数据仍然稀少。DOT与MRI互补，因为它提供了极好的时间分辨率，可以应用于护理点。此外，DOT提供代谢率的同步分析，同时只牺牲轻微的解剖分辨率。

DESCRIPTION (provided by applicant): This Career Development Award will support the growth of Dr. Daniel Licht into an independent clinical investigator with specialization in pediatric cerebrovascular injury. Dr. Licht's primary career development goal is to establish a multi-disciplinary research program encompassing the fields of neurology, critical care, and neuroimaging. To achieve these goals, Dr. Licht proposes collaborations between physicists and clinicians to develop new non-invasive methods for measuring cerebral blood flow (CBF) in newborn infants. Through modification and application of new imaging technologies, the proposed research will investigate the role of CBF in acquired brain injury in infants with severe congenital heart defects (CHD). CBF represents an important physiologic parameter for the understanding, diagnosis and management of neonatal brain disorders, and plays a pivotal role in brain injury in infants with severe CHD before heart surgery. In previous studies, Dr. Licht has found that deranged cerebrovascular physiology was associated with pre-operative structural brain injury. To further investigate this association, he proposes to measure and compare global and regional brain volumes in infants with CHD to those without CHD, and determine whether these differences are related to an altered CBF. Dr. Licht will use MRI based techniques to make these measurements and will test diffuse optic tomography (DOT) for comparative measurements. To date, both normative and disease data on pediatric brain perfusion remain sparse due to the lack of suitable techniques for CBF measurement. DOT is complimentary to MRI in that it offers excellent temporal resolution and can be applied at the point of care. Furthermore, DOT offers concurrent analysis of metabolic rate while sacrificing only mild anatomic resolution.