Improving SENSE MRI for Spiral and Echo-planar Imaging in Stroke

描述(由申请人提供)：动机-缺血性中风是一种常见的、往往是毁灭性的疾病，仍然是全球死亡和残疾的主要原因。成功的治疗将对中风发病率产生重大影响，并将减少与这种使人衰弱的疾病相关的社会经济负担。现在有大量的数据表明，基于MR的DWI、PWI和MRA有助于识别那些特别可能从再灌注治疗中受益而不是受到伤害的患者亚群。多层螺旋CT(MDCT)的进步也改善了对急性卒中患者的诊断评估，对两种模式的最佳检查进行比较评估是及时的。目的：该项目有一个技术开发部门，进一步改进了DWI、PWI和CE-MRA的MRI方法，并在一个临床部门中评估了这些方法在急性中风患者中的诊断敏感性和特异性以及临床产量，并与现有最好的MDCT方法(CT、CTP、CTA)进行了比较。方法-并行成像将是该项目的一个主要主题。具体地说，将改进螺旋、螺旋桨和笛卡尔数据的获取和快速重建方法。将开发DWI和PWI方法来改善量化，同时减少几何失真和运动伪影，并显著提高空间分辨率。将开发新的对比度增强的MRA采集方案和重建方法。在DWI、PWI和CE-MRA的发展之后，将进行广泛的体模和志愿者研究，以评估图像质量。这些优化的MR方法的诊断敏感性和特异性以及临床效果将在120名连续的急性中风患者中进行比较(在症状出现后6-12小时内)，并采用通道多层螺旋CT提供的最佳灌注和血管成像方法。意义--这项研究的成功将有助于显著改进多线圈并行成像采集和重建方法。临床上，我们期望这项前瞻性研究能更好地了解MRI和MDCT对急性卒中患者的影像诊断能力。此外，它还将提供工具，帮助确定将从再灌注治疗中受益的患者，并排除与再灌注相关的脑出血的高风险患者。

DESCRIPTION (provided by applicant): MOTIVATION - Ischemic stroke is a common and often devastating condition that continues to be a leading cause of death and disability worldwide. Successful treatment will have a great impact on stroke morbidity and will reduce the socio-economic burden associated with this debilitating disease. Considerable data are now available indicating that MR-based DWI, PWI, and MRA are useful for identifying subgroups of patients who are particularly likely to benefit from, rather than be harmed by, reperfusion therapy. The advancement of multi-detector CT (MDCT) has also improved the diagnostic evaluation of acute stroke patients and a comparative evaluation of optimal exams from both modalities is timely. AIMS - This project has a technology development arm in which MRI methods for DWI, PWI and CE- MRA are improved further, and a clinical arm in which these methods are evaluated in acute stroke patients and MRI's diagnostic sensitivity and specificity as well as clinical yield is compared with the best available MDCT methods (CT, CTP, CTA). METHODS - Parallel imaging will be a major theme of this project. Specifically, acquisition and fast reconstruction methods for spiral, PROPELLER, and Cartesian data will be improved. DWI and PWI methods will be developed to improve quantitation while simultaneously reducing geometric distortions and motion artifacts and significantly improving spatial resolution. New contrast-enhanced MRA acquisition schemes and reconstruction methods will be developed. The development of DWI, PWI, and CE-MRA will be followed by extensive phantom and volunteer studies to assess the image quality. The diagnostic sensitivity and specificity as well as the clinical yield of these optimized MR methods will be compared in 120 consecutive acute stroke patients (within 6-i2hrs after onset of symptoms) with the most optimal perfusion and angiographic methods afforded by a 64-channel MDCT. SIGNIFICANCE - The success of this research effort will serve to significantly improve multi-coil parallel imaging acquisition and reconstruction methods. Clinically, we anticipate that this prospective study will provide a better understanding of the diagnostic capability of both MRI and MDCT for imaging acute stroke patients. Moreover, it will provide tools to help identify patients who will benefit from reperfusion therapies and to exclude patients who are at high risk for reperfusion-related brain hemorrhage.