Improved imaging of carotid plaque using high-resolution, motion-corrected 3D MRI

 描述（由申请人提供）：我们在本项目中的目标是克服阻碍MRI成为颈动脉疾病评价临床标准的主要障碍。颈动脉MRI的独特之处在于，除了直径狭窄百分比的临床相关测量外，它还可以准确测量易损斑块标记物。除了颈动脉狭窄，在研究环境中使用MRI的研究发现，颈动脉斑块内炎症（IPI）、斑块内出血（IPH）、坏死核心（NC）和纤维帽（FC）厚度和破坏是重要的卒中风险因素。虽然MRI有可能测量这些因素，但在临床环境中使用颈动脉MRI仍然存在主要障碍。这些问题包括：1）缺乏针对所有患者颈动脉分叉解剖位置的特定线圈; 2）缺乏高分辨率MRI序列，无法在存在呼吸、心脏和吞咽运动的情况下准确测量管腔、狭窄和斑块成分。 在这个项目中，我们将：1）开发一种新型颈动脉成像线圈，线圈架上的模块化可互换阵列与遇到的患者颈部解剖结构范围相匹配; 2）开发创新的脉冲序列，以准确测量颈动脉管腔、狭窄和斑块成分; 3）开发脉冲序列方法和重建算法，以检测和纠正运动破坏的测量结果; 4）通过与组织学比较验证这些结果。定制的受试者适配RF线圈的开发将增加SNR并允许更高的空间和时间分辨率。模块化线圈的SNR增加加上运动鲁棒性序列将提高识别体内斑块成分的准确性。这将为未来使用颈动脉MRI的研究奠定基础，以最佳地表征卒中风险并监测针对降低IPI、IPH、NC和稳定FC的治疗效果。这些方法方便，一致，准确地描绘颈动脉管腔和斑块成分，将克服使用MRI作为临床标准，在表征颈动脉疾病的主要障碍。这将促进颈动脉MRI从MRI方法已经开发的研究环境向普通诊所的过渡，在普通诊所中，将获得个体患者的益处，并最终降低社会成本。

 DESCRIPTION (provided by applicant): Our goal in this project is to overcome major barriers preventing MRI from being the clinical standard for carotid disease evaluation. Carotid MRI is unique in that it has the potential to accurately measure vulnerable plaque markers in addition to the clinically relevant measurement of percent diameter stenosis. In addition to carotid stenosis, studies using MRI in the research setting have found that carotid intraplaque inflammation (IPI), intraplaque hemorrhage (IPH), necrotic core (NC), and fibrous cap (FC) thickness and disruption are important stroke risk factors. Although MRI has the potential to measure these factors, major barriers still exist to using carotid MRI in the clinical setting. These include 1) he lack of a coil specific to the anatomic location of the carotid bifurcation in all patients and 2) he lack of high-resolution MRI sequences to accurately measure lumen, stenosis, and plaque components in the presence of respiratory, cardiac, and swallowing motion. In this project we will: 1) develop a novel carotid imaging coil with modular interchangeable arrays on formers that match the range of patient neck anatomy encountered; 2) develop innovative pulse sequences to accurately measure carotid lumen, stenosis and plaque components; 3) develop pulse sequence methods and reconstruction algorithms to detect and correct motion-corrupted measurements; and 4) validate these results by comparison with histology. The development of tailor-made subject fitting RF coils will increase SNR and allow higher spatial and temporal resolution. This increased SNR from the modular coils coupled with motion- robust sequences will increase accuracy of identifying in-vivo plaque components. This will lay the foundation for future studies using carotid MRI to optimally characterize stroke risk and monitor treatment effects geared toward decreasing IPI, IPH, NC, and stabilizing the FC. These methods that conveniently, consistently, and accurately depict carotid lumen and plaque components will overcome the major barriers to the use of MRI as the clinical standard in characterizing carotid disease. This will facilitate the transition of carotid MRI from the research setting where MRI methods have been developed to the general clinic where benefit to the individual patient will be obtained and costs to society will ultimately be reduced.