MRI EVALUATION OF THE EFFECTS OF CORONARY ARTERY DISEASE

冠心病(CAD)是一个主要的公共健康问题；目前 在CAD中评价心脏的常规影像方法有很多种 限制。心脏的磁共振成像(MRI)有很好的 有潜力改善CAD的诊断和管理，但它需要 进一步开发和评估。该计划的长远目标 本申请中提出的工作是在临床上产生一种改进的 磁共振成像评价冠心病的实用方法及其应用 实用程序。具体目标是：1)开发改进的磁共振成像 血流灌注成像和分析技术及其在心脏手术中的集成 全面的心脏MRI检查，2)这些MRI的验证 慢性心肌缺血动物模型的技术，以及3) 这些技术在一系列人体心脏移植中的初步评价 病人。 心脏成像方法的技术发展将包括 快速血流灌注成像的发展(通过快速成像 第一批MR造影剂)和组织 表征MRI技术，以及它们与以前的集成 开发的区域功能MRI技术(使用空间标记 磁化调制(SPAM))。相应的图像分析 程序将在先前为 分析标记的磁共振图像，SPAMMVU。数据可视化计划将 既要有助于研究的主要解释，也要有助于 将分析结果传达给推荐的临床医生。这些 成像和分析技术将在猪的猪模型中得到验证 慢性缺血，包括独立的血流灌注测量 微球。人体研究将包括正常受试者和 有限系列的冠心病患者；这将使我们能够执行 这些MRI方法在CAD和TO中的应用价值的初步评价 为更明确的评估做好计划。核磁共振研究的结果 将与传统的放射性核素成像研究和 病人的临床病程。

Coronary artery disease (CAD) is a major public health problem; current conventional imaging methods to evaluate the heart in CAD have many limitations. Magnetic resonance imaging (MRI) of the heart has great potential to improve the diagnosis and management of CAD, but it needs further development and evaluation. The long term objectives of the work proposed in this application are to produce an improved, clinically practical method for MRI evaluation of CAD and to demonstrate its utility. The specific aims are: 1) development of improved MRI perfusion imaging and analysis techniques and their integration into a comprehensive cardiac MRI examination, 2) validation of these MRI techniques in an animal model of chronic myocardial ischemia, and 3) preliminary evaluation of these techniques in a series of human cardiac patients. The technical development of cardiac imaging methods will include development of rapid perfusion imaging (through rapid imaging of the first passage of a bolus of MR contrast agent) and tissue characterization MRI techniques, and their integration with previously developed regional function MRI techniques (using tagging with spatial modulation of magnetization (SPAMM)). The corresponding image analysis programs will be developed within a program previously developed for the analysis of tagged MR images, SPAMMVU. Data visualization programs will be developed both to aid the primary interpretation of the study and to convey the results of the analysis to the referring clinician. These imaging and analysis techniques will be validated in a porcine model of chronic ischemia, including independent perfusion measurement with microspheres. Human studies will include both normal subjects and a limited series of patients with CAD; this will enable us to perform an initial evaluation of the usefulness of these MRI methods in CAD and to plan for a more definitive evaluation. The results of the MRI studies will be compared with both conventional radionuclide imaging studies and the patient's clinical course.