Time-efficient accurate 3D myocardium scar quantification using RAPID imaging

使用 RAPID 成像进行省时、准确的 3D 心肌疤痕定量

• 批准号: 8823456
• 负责人: CHUN YUAN
• 金额: $ 24.61万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-29 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8823456
• 关键词: Adoption; Attenuated; Biological Markers; Blood; Cardiac; Cause of Death; Characteristics; Cicatrix; Clinical; Clinical Management; Coronary heart disease; Detection; Diagnostic; Discipline of Nuclear Medicine; Disease; Ensure; Environment; Equilibrium; Evaluation; Face; Financial compensation; Goals; Gold; Image; Imaging Techniques; Infarction; Injection of therapeutic agent; Intraventricular; Location; Magnetic Resonance; Magnetic Resonance Imaging; Motion; Myocardial; Myocardial Infarction; Myocardium; Necrosis; Noise; Patients; Pattern; Phase; Physiologic pulse; Recovery; Recurrence; Reliance; Research; Residual state; Sampling; Scanning; Signal Transduction; Symptoms; Techniques; Time; Tissues; United States; Ventricular; base; clinical Diagnosis; clinical practice; design; image reconstruction; improved; novel; outcome forecast; public health relevance; reconstruction; tool

DESCRIPTION (provided by applicant): Coronary Heart Disease (CHD) remains the No.1 cause of death in the United States. The majority patients with CHD develop serious clinical symptoms, including myocardial infarction (MI), and the recurrence rate of MI becomes significantly increased after the initial attack. The accurate detection and quantification of myocardial scarring post-MI is critical for clinical diagnosis because it has been strongly associated with cardiac function, proven to be a predictive indicator for treatment prognosis, and is widely used as a biomarker for treatment evaluation. The current gold standard of MI scarring detection is to use magnetic resonance (MR) based Phase Sensitive Inversion Recovery (PSIR) technique, which can restore the polarity of the spin magnetization after inversion pulses. As 3D scans have been found to provide higher quantification and detection accuracy than 2D scans, the PSIR technique still faces two major challenges to fully adapt itself into a clinically viable D technique: 1) Low time-efficiency. Because the PSIR technique requires an extra fully sampled reference scan to restore the magnetization orientation, thus doubling scan time compared to non-PSIR LGE scans. As a result, although 3D PSIR can potentially provide improved detection and quantification accuracy, they have only been explored in research environments. 2) Poor contrast between the scar and bright blood pool. Although the PSIR reconstruction ensures strong scar/tissue contrast, the usually bright blood pool signal remains a confounding factor in quantifying scars, esp. for a subtle subendocardial scar. Our long-term goal is to develop an MR imaging technique as first-line diagnostic tool for myocardial scar detection/quantification in regular clinical practice. A newly designed RAPID reconstruction that does not require the 2nd acquisition for PS reconstruction will be used to improve the time efficiency and it will be combined with dedicated blood suppression techniques to improve the scar/blood contrast. The accuracy of the new techniques will also be validated in a clinical environment. By successfully achieving both aims, we expect to develop and validate a time-efficient clinically orientated 3D viability imaging technique that can significantly improve the current MI detection/quantification accuracy.

描述（由申请人提供）：冠心病（CHD）仍然是美国第一大死因。大多数冠心病患者会出现严重的临床症状，包括心肌梗塞（MI），并且首次发作后MI的复发率显着增加。心肌梗死后心肌疤痕的准确检测和量化对于临床诊断至关重要，因为它与心脏功能密切相关，被证明是治疗预后的预测指标，并被广泛用作治疗评估的生物标志物。目前 MI 疤痕检测的黄金标准是使用基于磁共振 (MR) 的相敏反转恢复 (PSIR) 技术，该技术可以在反转脉冲后恢复自旋磁化强度的极性。由于3D扫描被发现比2D扫描提供更高的量化和检测精度，PSIR技术仍然面临着两个主要挑战，以使其完全适应临床上可行的D技术：1）低时间效率。因为 PSIR 技术需要额外的完全采样参考扫描来恢复磁化方向，因此与非 PSIR LGE 扫描相比，扫描时间增加了一倍。因此，尽管 3D PSIR 有可能提高检测和量化精度，但它们仅在研究环境中进行了探索。 2）疤痕与明亮的血池对比度差。尽管 PSIR 重建确保了强烈的疤痕/组织对比度，但通常明亮的血池信号仍然是量化疤痕的混杂因素，尤其是。用于微妙的心内膜下疤痕。我们的长期目标是开发磁共振成像技术作为常规临床实践中心肌疤痕检测/量化的一线诊断工具。新设计的RAPID重建不需要第二次采集进行PS重建，将用于提高时间效率，并将与专用的血液抑制技术相结合，以改善疤痕/血液对比度。新技术的准确性也将在临床环境中得到验证。通过成功实现这两个目标，我们期望开发和验证一种省时、面向临床的 3D 活力成像技术，该技术可以显着提高当前 MI 检测/量化的准确性。