Quantitative Simultaneous Cardiac PET-MR

摘要 对已知或疑似缺血性心肌病患者的评估和最佳处理需要 评价心肌缺血的程度和范围以及心肌梗死的程度 梗塞和疤痕。而PET心肌灌注成像提供了最可靠的方法来评估 缺血的存在和严重程度，目前受到心脏和呼吸系统的退化的限制 动议。另一方面，心脏磁共振(CMR)目前提供了最准确的检测方法 并评估心肌瘢痕的程度。它还可以识别临床上重要的晚期Gd 与各种非缺血性心肌病相关的增强模式，并提供对 全球和区域室壁运动异常。此外，CMR还可以用来估计跨室壁 给定梗死的范围，这与冠脉术后恢复的可能性直接相关 血运重建，从而准确识别存活的心肌。然而，量化疾病的严重性 缺血，特别是当同时存在疤痕时，较少出现CMR。为了夺取 利用每种技术的固有优势并解决这些模式的根本局限性， 我们建议使用同步PET-MR来提供对存活心肌的全面评估 以及对非穿透性心肌梗死患者残余缺血的评估。我们将写一部小说 列表模式PET重建框架，将MR测量的心脏和呼吸运动合并到 PET发射系统矩阵以及随时间变化的衰减图和位置依赖点 扩散函数。

Abstract Evaluation and optimal management of patients with known or suspected ischemic cardiomyopathy requires an assessment of the magnitude and extent of myocardial ischemia as well as the extent of myocardial infarction and scar. While PET myocardial perfusion imaging offers the most robust method to evaluate the presence and severity of ischemia, it is currently limited by the degradation due to both cardiac and respiratory motion. On the other hand, cardiac MR (CMR) currently offers the most accurate method to detect the presence and assess the extent of myocardial scar. It can also identify clinically important late gadolinium enhancement patterns associated with various non-ischemic cardiomyopathies and provides an assessment of global and regional wall motion abnormalities. Furthermore, CMR can be used to estimate the transmural extent of a given infarct, which directly correlates with the likelihood of recovery post coronary revascularization, and thus accurately identifies viable myocardium. However, quantification of the severity of ischemia, particularly when concomitant scar is also present, is less established with CMR. In order to take advantage of the inherent strengths of each technique and resolve fundamental limitations of these modalities, we propose to use simultaneous PET-MR to provide a comprehensive assessment of viable myocardium as well as an assessment of residual ischemia in patients with non-transmural infarctions. We will develop a novel list-mode PET reconstruction framework that incorporates cardiac and respiratory motion measured by MR into PET emission system matrix as well as the time-dependent attenuation map and the position dependent point spread function.