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Carotid Intraplaque Hemorrhage: MRI of Therapeutic Response and Clinical Sequelae

颈动脉斑块内出血：治疗反应和临床后遗症的 MRI

基本信息

批准号：
10092205
负责人：
THOMAS HATSUKAMI
金额：
$ 71.69万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-25 至 2023-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10092205
关键词：
3-Dimensional Achievement Blood Pressure Brain Carotid Artery Plaques Carotid Atherosclerotic Disease Carotid Endarterectomy Carotid Stenosis Cerebral Infarction Characteristics Clinical Clinical Research Clinical Trials Cohort Studies Data Development Diastolic blood pressure Disease Progression Enrollment Event Foundations Funding Future Goals Gold Hemorrhage Histology Home Blood Pressure Monitoring Image Imaging Techniques Inflammation Inflammatory Knowledge Lesion Lipids Magnetic Resonance Imaging Measures Methods Monitor Participant Pathogenesis Pathologic Permeability Prospective Studies Prospective cohort study Protocols documentation Pulse Pressure Recurrence Reproducibility Research Resolution Risk Risk Factors Role S-nitro-N-acetylpenicillamine Scanning Schedule Series Signal Transduction Solid Source Stroke Stroke prevention Surface Techniques Testing Time Tissues Ulcer United States National Institutes of Health Visit base blood pressure regulation clinical diagnostics contrast enhanced disability follow-up hemodynamics high risk imaging study inflammatory marker insight modifiable risk monitoring device mortality neovascularization neovasculature novel prospective recruit tool treatment response treatment strategy

项目摘要

Abstract Magnetic resonance imaging (MRI) is a proven technique that can non-invasively identify key pathological features of carotid atherosclerosis. Prior MRI studies have shown that carotid intraplaque hemorrhage (IPH) and lumen surface disruption are associated with increased risk for future ischemic events, and that IPH is associated with more rapid plaque progression and presence of greater inflammatory activity and neovascularization. In our current cohort study, we tested the hypothesis that despite statin therapy and aggressive regulation of blood pressure, stability of carotid lesions with IPH is compromised. Findings to date support our original hypothesis. Further, preliminary interim analysis of our data suggest potential risk factors and MRI signal characteristics that are associated with the progression of IPH. However, longer-term follow-up is critical to confirm these promising initial findings. The central hypotheses of this competing renewal are that i) hemodynamic factors and increased plaque neovascularization are associated with the development of new or repeated IPH, and ii) the rate of plaque progression is driven by repeated IPH that can be characterized by MR T1 and T2 mapping -- a quantitative means to assess IPH resolution and recurrence. The long-term goals of our research is to utilize MRI in prospective clinical studies to gain insight into the pathogenesis of the high-risk carotid plaque, to identify risk factors associated with more rapid progression, and ultimately, to establish carotid plaque imaging as a clinical diagnostic tool for reduction of incident stroke. Globally, stroke remains one of the leading causes of serious long-term disability and mortality and carotid atherosclerosis is a significant contributor. A better understanding of its pathogenesis is critically needed to develop more effective methods for primary and secondary stroke prevention.

摘要磁共振成像（MRI）是一种经过验证的技术，可以非侵入性地识别关键的病理性颈动脉粥样硬化的特征。先前的MRI研究表明，颈动脉斑块内出血（IPH）和管腔表面破坏与未来缺血性事件的风险增加有关，IPH是与更快的斑块进展和更大的炎症活动的存在相关，新生血管形成在我们目前的队列研究中，我们验证了一个假设，即尽管他汀类药物治疗和积极的调节，血压，IPH的颈动脉病变的稳定性受到损害。迄今为止的调查结果支持我们最初的假说.此外，初步的中期分析我们的数据表明，潜在的危险因素和MRI信号与IPH进展相关的特征。然而，长期随访对于证实了这些有希望的初步发现。这种竞争性更新的中心假设是：i）血流动力学因素和斑块增加新生血管形成与新发或复发IPH的发生相关，以及ii）斑块发生率进展是由反复的IPH驱动的，其特征可以通过MR T1和T2映射来表征，这是一个定量的评估IPH消退和复发的方法。我们研究的长期目标是在前瞻性临床研究中利用MRI来深入了解高危颈动脉斑块的发病机制，以确定与更快进展相关的风险因素，并最终建立颈动脉斑块成像作为临床诊断工具，以减少中风的发生。在全球范围内，中风仍然是严重的长期残疾和死亡的主要原因之一，动脉粥样硬化是一个重要因素。迫切需要更好地了解其发病机制，开发更有效的一级和二级预防中风的方法。

项目成果

期刊论文数量（18）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Carotid Intraplaque Hemorrhage Imaging with Quantitative Vessel Wall T1 Mapping: Technical Development and Initial Experience.

颈动脉斑块内出血成像与定量血管壁 T1 映射：技术开发和初步经验

DOI：
10.1148/radiol.2017170526
发表时间：
2018-04
期刊：
Radiology
影响因子：
19.7
作者：
Qi H;Sun J;Qiao H;Chen S;Zhou Z;Pan X;Wang Y;Zhao X;Li R;Yuan C;Chen H
通讯作者：
Chen H

Blood Pressure Is a Major Modifiable Risk Factor Implicated in Pathogenesis of Intraplaque Hemorrhage: An In Vivo Magnetic Resonance Imaging Study.

DOI：
10.1161/atvbaha.115.307043
发表时间：
2016-04
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
0
作者：
Sun J;Canton G;Balu N;Hippe DS;Xu D;Liu J;Hatsukami TS;Yuan C
通讯作者：
Yuan C

Improved carotid lumen delineation on non-contrast MR angiography using SNAP (Simultaneous Non-Contrast Angiography and Intraplaque Hemorrhage) imaging.

DOI：
10.1016/j.mri.2019.06.012
发表时间：
2019-10
期刊：
Magnetic resonance imaging
影响因子：
2.5
作者：
Haining Liu;Jie Sun;D. Hippe;Wei Wu;B. Chu;N. Balu;T. Hatsukami;C. Yuan
通讯作者：
Haining Liu;Jie Sun;D. Hippe;Wei Wu;B. Chu;N. Balu;T. Hatsukami;C. Yuan

Adventitial perfusion and intraplaque hemorrhage: a dynamic contrast-enhanced MRI study in the carotid artery.

DOI：
10.1161/strokeaha.111.000435
发表时间：
2013-04
期刊：
Stroke
影响因子：
8.3
作者：
Sun J;Song Y;Chen H;Kerwin WS;Hippe DS;Dong L;Chen M;Zhou C;Hatsukami TS;Yuan C
通讯作者：
Yuan C

Evaluation of carotid atherosclerotic plaque surface characteristics utilizing simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) technique.

利用同步非造影血管造影和斑块内出血 (SNAP) 技术评估颈动脉粥样硬化斑块表面特征。