A new paradigm of cardiovascular MRI for pediatric congenital heart disease

 描述（由申请人提供）：先天性心脏病（CHD）是最常见的先天性缺陷，影响约1%的活产婴儿。心血管MRI（CMR）最初是为成人开发和优化的，现在越来越多地用于儿童CHD患者，以补充超声心动图和侵入性血管造影术，用于心脏和血管的解剖和功能评价。对于儿童，无创性，不受限制的视野，缺乏对比剂肾毒性和无电离辐射使MRI成为一种有吸引力的成像方式，因为许多患者可能需要长期连续成像和随访。然而，当前CMR受到屏气期、捕获钆（Gd）团注的首次通过的需要以及心脏电影MRI中相对较厚的2D切片的限制。因此，尽管产生了关于心外血管解剖结构的非常详细的信息，但是当前CMR方法不能提供动态心内解剖结构（诸如心腔、瓣膜、冠状动脉和其他脉动血管）的可比定义，尽管这些结构的状态通常决定了治疗计划的基础。我们提出了一个新的模式CMR在儿科CHD，以解决这些问题。该项目的完成将导致一组MRI脉冲序列、图像采集和重建策略CMR在儿科CHD患者中的临床部署，并在一组患者中成功验证其诊断价值。

 DESCRIPTION (provided by applicant): Congenital heart disease (CHD) is the most common congenital defect affecting approximately 1% of live births. Initially developed and optimized for adults, cardiovascular MRI (CMR) is increasingly used in pediatric CHD patients to complement echocardiography and invasive angiography for anatomical and functional evaluation of the heart and blood vessels. For children, the non-invasiveness, unrestricted field of view, lack of contrast nephrotoxicity and absence of ionizing radiation make MRI an attractive imaging modality, as many of the patients will likely need sequential imaging and follow-up in the long term. However, current CMR is limited by the breath-holding period, the need to capture the first-pass of a gadolinium (Gd) bolus and relatively thick 2D slices in cardiac cine MRI. Consequently, despite yielding exquisitely detailed information on extra-cardiac vascular anatomy, current CMR methods fall short of providing comparable definition of dynamic intra-cardiac anatomy, such as the cardiac chambers, valves, coronary arteries, and other pulsatile blood vessels, despite the fact that the status of these structures often determines the basis for treatment planning. We propose a new paradigm of CMR in pediatric CHD to address these issues. Completion of the project will result in the clinical deployment of a set of MRI pulse sequences, image acquisition and reconstruction strategies CMR in pediatric CHD patients, and successful validation in a cohort of patients of its diagnostic value.