Vastly Accelerated Dynamic Spiral MR Liver Imaging

描述(申请人提供)：肝纤维化及其最晚期，肝硬变，是慢性和急性肝病的后果。纤维化导致肝功能丧失以及局部和整体血流灌注改变。目前，评估纤维化的金标准是肝活检，这是一种侵入性技术。其长期目标是开发一种可靠和准确的非侵入性方法来检测和分期肝纤维化和肝硬变。作为这一目标的一部分，这项研究的目标是开发一种具有高度重复性的动态对比增强磁共振成像(DCE MRI)。我们的假设是，通过使用连续的MR数据采集和基于敏感性的对比剂浓度测量，可以实现DCE-MRI灌注参数测量的高重复性。这项拟议研究的基本原理是，拟议的灌注法将能够量化纤维化引起的细微和早期的肝功能变化，以便在后期进展为肝硬变或恶性肿瘤之前进行干预。为了验证这一假设，我们追求以下两个具体目标：1)发展一种使用连续高帧速率图像采集和基于敏感性的浓度测量的MR灌注成像方法；2)评估其在一组健康受试者和一组经活检证实的肝硬变患者身上的重测重复性。预计这种方法最终将能够区分肝纤维化的中晚期和晚期。这可能会产生积极的影响，因为它将提供监测慢性肝病的疾病进展和治疗效果的能力。

DESCRIPTION (provided by applicant): Liver fibrosis and its most advanced stage, cirrhosis, are consequences of chronic and acute hepatic disease. Fibrosis leads to a loss of liver function and both regional and global perfusion changes. Currently, the gold standard for assessing fibrosis is liver biopsy, which is an invasive technique. The long-term goal is to develop a robust and accurate non-invasive method for detecting and staging liver fibrosis and cirrhosis. The objective of this research, as part of that goal, is to develop a dynamic contrast enhanced magnetic resonance imaging (DCE MRI) that is highly reproducible. Our hypothesis is that a high reproducibility of DCE-MRI perfusion parameter measurement can be achieved using by using a continuous MR data acquisition and a contrast concentration measurement based on susceptibility. The rationale for the proposed research is that the proposed perfusion method will enable the quantification of subtle and early changes in liver function induced by fibrosis to allow for intervention prior to progression to cirrhosis or malignancies at a later stage. To test the hypothesis, the following two specific aims are pursued: 1) the development a MR perfusion imaging method using a continuous high frame rate image acquisition and susceptibility based concentration measurement and 2) the evaluation of its test-retest reproducibility in a group of healthy subjects as well as a group of patients with biopsy proven cirrhoses. It is expected that this method will ultimately lead to the ability to distinguish intermediate from advanced stages of liver fibrosis. This is likely to have a positive impact, because it would provide the ability to monitor disease progression and treatment efficacy for chronic liver disease.