Cine-DENSE MRI to study right-and left ventricular forms of cardiomyopathy in SA

描述(由申请人提供)：这项研究将主要在南非开普敦大学(UCT)和南非开普敦的Groote Schuur医院(GSH)进行，与Mayosi、Meintjes和Smedema博士合作，作为NIH第一号拨款R01 EB001763的延伸。总体目标是将Cine-Density(位移编码与刺激回声)MRI应用于研究在撒哈拉以南非洲特别流行的左、右室心肌病中出现的室壁运动异常，并开发用于定量分析此类图像的高度自动化算法。心肌病是非洲所有心血管疾病中最大的挑战，因为这些疾病在仍受饥荒和瘟疫困扰的社会中发病率更高；在资源匮乏的环境中由于缺乏专门的心脏病学调查而难以诊断；无法获得心脏移植等有效干预措施；以及与这些往往不可逆转的心肌疾病有关的高死亡率。心肌病的室壁运动异常可能是临床可检测到心力衰竭之前最早的功能异常，并可能提供有关心脏收缩功能的直接信息。以往的室壁运动成像技术要么空间分辨率低，要么精度差。Cine-Density以像素级的空间分辨率实现了对心脏周期中的心肌运动的高精度跟踪。最近，切片跟踪已被用于电影密度，以实现准确的3D左心室(LV)运动跟踪。这些方法还没有应用于右室，也没有实现左、右室心肌的自动分割。Cine-Density还没有被应用于心肌病的室壁运动异常的研究，并且提供了比以前研究中使用的技术更高的空间分辨率。具体地说，室壁运动异常与致心律失常性右室心肌病(ARVC)和围产期心肌病(PCM)患者1年后的预后相关。将开发工具，通过开发更健壮的相位展开算法来跟踪LV和RV的心肌运动；将使用基于运动的算法实现自动心肌分割，并将应变编码(SENC)和高密度MRI相结合，以像素分辨率计算3D心肌内应变张量。

DESCRIPTION (provided by applicant): This research will be conducted primarily in South Africa at the University of Cape Town (UCT) and Groote Schuur Hospital (GSH) in Cape Town, South Africa, in collaboration with Drs Mayosi, Meintjes, and Smedema, as an extension of NIH grant #1 R01 EB001763. The overall aim is to apply cine-DENSE (Displacement Encoding with Stimulated Echos) MRI to the study of wall motion abnormalities that occur in left-and right ventricular forms of cardiomyopathy that are particularly prevalent in sub-Saharan Africa and to develop highly automated algorithms for the quantitative analysis of such images. The cardiomyopathies pose the greatest challenge of all the cardiovascular diseases in Africa because of their greater prevalence in societies still plagued by diseases of famine and pestilence; difficulty in diagnosis due to the lack of specialized cardiological investigations in resource poor environments; the lack of access to effective interventions such as heart transplantation; and the high mortality associated with these often irreversible disorders of heart muscle. Wall motion abnormality in cardiomyopathy may be the earliest functional abnormality before clinically detectable heart failure and may provide direct information about the contractile function of the heart. Previous wall motion imaging techniques suffer from either low spatial resolution or poor accuracy. Cine-DENSE achieves tracking of the myocardial motion through the cardiac cycle at pixel-wise spatial resolution with high accuracy. Slice following has recently been implemented for cine-DENSE achieving accurate 3D left ventricular (LV) motion tracking. These methodologies have not been applied to the RV and automatic segmentation of the LV and RV myocardium has not been achieved. Cine-DENSE has not been applied to the study of wall motion abnormalities that occur in cardiomyopathy and offers higher spatial resolution than techniques used in previous studies. Specifically, wall motion abnormality will be correlated with outcome at 1 year in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and peripartum cardiomyopathy (PCM). Tools will be developed for 3D tracking of the myocardial motion of both the LV and RV by developing a more robust phase unwrapping algorithm; automatic myocardial segmentation will be achieved using a motion-based algorithm, and 3D intramyocardial strain tensors will be computed at a pixel resolution by combining Strain Encoded (SENC) and DENSE MRI.