3D MRI Characterization of High-Risk Carotid Artery Plaques without Contrast Media

无需造影剂的高风险颈动脉斑块的 3D MRI 表征

• 批准号: 9300995
• 负责人: Debiao Li
• 金额: $ 43.75万
• 依托单位: CEDARS-SINAI MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-20 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9300995
• 关键词: Arterial Fatty Streak; Atherosclerosis; Blood; Calcified; Caliber; Cardiovascular Diseases; Cardiovascular system; Carotid Arteries; Carotid Artery Plaques; Carotid Atherosclerotic Disease; Complex; Contrast Media; Cost Savings; Data; Deglutition; Detection; Development; Diffusion Magnetic Resonance Imaging; Event; Fibrosis; Future; Gadolinium; Goals; Hemorrhage; High Prevalence; Histopathology; Image; Image Enhancement Agent; Kidney Failure; LDL Cholesterol Lipoproteins; Life Style; Lipids; Magnetic Resonance Imaging; Measures; Medical; Methods; Morphologic artifacts; Motion; Necrosis; Patients; Pattern; Physiologic pulse; Probability; Protocols documentation; Protons; Recovery; Resolution; Risk; Rupture; Scheme; Signal Transduction; Slide; Specimen; Stroke; T2 weighted imaging; Techniques; Testing; Thinness; Time; Tissues; Transient Ischemic Attack; Treatment outcome; Validation; base; calcification; contrast imaging; cost; data acquisition; density; high risk; imaging modality; improved; neurovascular; outcome forecast; public health relevance; response

 DESCRIPTION (provided by applicant): The broad, long-term objective of the application is to improve the prognosis of patients with carotid atherosclerosis. We will develop and validate a fast and non-contrast-agent-enhanced 3D MRI technique to identify carotid atherosclerotic plaques that have a high probability of causing neurovascular events such as stroke or transient ischemic attack. Major features of high-risk carotid plaques include the presence of intra- plaque hemorrhage (IPH), calcification (CA), a large lipid-rich necrotic core (LRNC), and thin fibrous cap (FC). MRI is used extensively to characterize carotid artery plaques based on tissue signal patterns on multi- contrast-weighted images (T1-, T2-weighted imaging and time-of-flight) and contrast-agent-enhanced imaging. However, the conventional protocol has a number of major limitations, including: (1) Relatively low through- plane resolution (2-3 mm) with 2D techniques, potentially reducing the accuracy of plaque characterization due to the partial volume effect, 2) relatively long total image acquisition time (> 20 min), 3) image artifacts caused by swallowing during data acquisition, 4) complex plaque characterization using separate T1-, T2-, proton- density-weighted, time-of-flight, and contrast-agent-enhanced images, resulting in potential errors due to image misregistration between separate acquisitions, and most importantly, 5) the requirement of gadolinium-based- contrast-agent-enhanced imaging for LRNC characterization. As a result, patients with renal insufficiency will not be able to undergo this examination due to the risk of developing nephrogenic systemic fibrosis. Therefore, MRI techniques without gadolinium-based contrast media could be vitally important for patients with renal insufficiency, who also have high prevalence for cardiovascular disease. The goal of the application is to develop a new MRI technique and test the hypothesis that it reduces data acquisition time by a factor of 3 while without the need for contrast media as compared to the conventional protocol. Specific aims are: Aim 1: To develop the non-contrast-agent-enhanced, multi-contrast-weighted atherosclerosis characterization (NCE-MATCH) technique Aim 2: To validate high-risk carotid plaque features detected by NCE-MATCH using histopathology Aim 3: To verify that NCE-MATCH can detect atherosclerotic lipid depletion during lipid lowering therapy If successfully developed, the technique will be able to identify patients who are prone to future neurovascular events so life style changes or medical therapies can be initiated to reduce the risks. It will als provide a measure for evaluating the response to lipid lowering therapy, which is predictive of reduced risk. Compared to the conventional protocol, NCE-MATCH will allow imaging of patients with renal insufficiency due to its ability to avoid contrast agents. It also has the potential for considerable cost savings due to shorter imaging time and non-contrast-agent-enhanced imaging.

 描述（由应用提供）：应用的广泛，长期目标是改善颈动脉粥样硬化患者的预后。我们将开发和验证一种快速，非对比度增强的3D MRI技术，以鉴定颈动脉粥样硬化斑块，这些斑块具有引起神经血管事件（例如中风或短暂性缺血性发作）的可能性很高。高风险颈动脉斑块的主要特征包括存在斑型内出血（IPH），计算（CA），富含脂肪的大坏死核（LRNC）和薄纤维帽（FC）。 MRI广泛用于表征基于组织信号模式的颈动脉斑块（T1-，T2加权成像和飞行时间）以及对比度代理实力成像。但是，常规协议具有许多主要局限性，包括：（1）使用2D技术相对较低的平面分辨率（2-3 mm），可能会降低由于部分体积效应而导致的斑块表征的准确性，2）相对长的总图像获取时间（> 20分钟），在数据中散布的图像既有图像在数据中的吞咽过程中散布2个，3）plaeception2 scomplect plaifification 2质子密度加权，飞行时间和对比代理增强的图像，由于单独的采集之间的图像错过进行了图像误差而导致潜在的误差，最重要的是，5）对基于Gadolinium的对比反对代理 - 增强了LRNC表征的要求。结果，由于患有肾病性全身性纤维化的风险，肾功能不全的患者将无法进行此检查。因此，没有基于Gadolinium的对比培养基的MRI技术对于肾功能不全患者至关重要，肾脏功能不全，患有心血管疾病的患病率也很高。 The goal of the application Specific aims are: Aim 1: To develop the non-contrast-agent-enhanced, multi-contrast-weighted atherosclerosis characterization (NCE-MATCH) technique Aim 2: To validate high-risk carotid plaque features detected by NCE-MATCH using histopathology Aim 3: To verify that NCE-MATCH can detect atherosclerotic lipid depletion during lipid lowering therapy If该技术成功地开发了，将能够识别出容易发生神经血管事件的患者，因此可以开始生活方式变化或医疗疗法以降低风险。它将提供评估对脂质降低治疗的反应的措施，这可以预测风险降低。与常规方案相比，NCE匹配将允许对肾功能不全的患者进行成像，因为它避免了对比剂。由于成像时间较短和非对抗性代理增强成像，它还具有考虑成本节省的潜力。