Time-resolved MR methods for analysis of contrast and flow velocity in aneurysms

描述（由申请人提供）：该项目旨在开发新的磁共振成像能力，以描绘颅内动脉瘤的解剖结构，并阐明这些实体内的血流动力学。该项目的成功完成将带来更强大、可靠和高效的MRI方法，用于获取高分辨率3D血管成像和血管系统内的全7D血流测量。这将为确定颅内动脉瘤的解剖结构和功能提供一种系统和有条不紊的方法，并将为临床医生制定治疗这些疾病的策略提供重要的新指导。因此，该项目的具体目标是：1)利用当前MR硬件和软件的全部功能，使用具有一定复杂性的流幻影来确定最合适的成像方法，以捕获速度场的时间分辨信息并评估流腔。2)我们的目标是开发和评估用于显示、后处理和分析不同时间点和模式的几何和高维血流动力学数据的工具；3)在患者研究中测试目标1和目标2中开发的最佳技术，并评估监测解剖和生理变化的能力。目前获得MR血管造影和速度测定的方法是在人体研究的临床环境中开发的，很难进行系统和重复的研究。这些发展也缺乏真正的金标准，核磁共振测量和金标准技术之间的比较通常是定性的。复制体内血流条件的患者衍生模型将允许确定当前方法的局限性，并允许选择最合适的方法。结构变化位置的精确地图可以与作用于动脉瘤中这些位置的血流动力学力联系起来，这将提供信息，从而在特定患者的基础上深入了解动脉瘤疾病的进展。与公众健康相关：本提案旨在发展MR方法来评估脑内动脉瘤的结构和测量这些动脉瘤内的血流模式。一种稳健可靠的非侵入性评估这些区域结构和功能的方法的可用性，将使临床医生能够有效地评估这些疾病的患者，使他们免于动脉导管置入的相关风险。此外，非侵入性地确定颅内动脉瘤血流模式的能力，应该为了解导致一些动脉瘤保持稳定，而另一些动脉瘤生长，导致严重症状或破裂并极有可能造成破坏性脑损伤或死亡的潜在生理学提供新的见解。

DESCRIPTION (provided by applicant): This project is aimed at developing new MR imaging capabilities for depicting the anatomy of intracranial aneurysms, and to elucidate the hemodynamics within these entities. Successful completion of this project will lead to more robust, reliable and time-efficient MRI methods for acquiring high resolution 3D angiograms and fully 7D flow measurements within the vasculature. This will create a systematic and methodical approach to the determination of anatomy and function in intracranial aneurysms and will provide important new guidance to clinicians as they develop strategies to treat these disorders. The specific aims of this project are therefore: 1) to use flow phantoms with a range of complexity to determine the most suitable imaging approach for capturing time-resolved information on velocity fields and for evaluating the flow lumen, using the full capabilities of current MR hardware and software. 2) We aim to develop and evaluate tools for display, post-processing and analysis of geometric and high dimensional, hemodynamic data from different time points and modalities; and 3) Test the optimal techniques developed in Aims 1 and 2 in patient studies, and evaluate the ability to monitor changes in anatomy and physiology over time. Current methods for acquiring MR angiography and velocity determination have been developed in the clinical setting on human studies where it is difficult to perform systematic and repeated studies. Those developments also lack a true gold standard and comparisons between MR measurements and gold standard techniques have typically been qualitative. Patient-derived models that replicate in vivo flow conditions will permit the determination of the limits of current methods, and allow for selection of the most suitable approach. Accurate maps of locations of structural changes that can be linked to the hemodynamic forces acting at those locations in aneurysms will provide information that will provide an insight on the progression of aneurysmal disease on a patient-specific basis. Relevance to public health: This proposal aims to develop MR methods for assessing the structure of aneurysms in the brain and for measuring blood flow patterns within those aneurysms. The availability of a robust and reliable method for non-invasively assessing structure and function in these territories will permit clinicians to effectively evaluate patients with these diseases, sparing them the associated risks of arterial catheterization. In addition, the ability to non-invasively determine blood flow patterns in intracranial aneurysms should provide new insights into the underlying physiology that causes some aneurysms to remain stable, and others to grow, resulting in profound symptoms or rupture with a high likelihood of devastating cerebral injury or death.