Quantitative ASL MR angiography and perfusion imaging for cerebral revascularization

用于脑血运重建的定量 ASL MR 血管造影和灌注成像

• 批准号: 10208990
• 负责人: Lirong Yan
• 金额: $ 40.84万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10208990
• 关键词: Algorithms; Anastomosis - action; Aneurysm; Angiography; Arteries; Blood Vessels; Blood flow; Cause of Death; Cerebral Revascularization; Cerebrovascular Disorders; Chronic; Clinical; Complex; Consensus; Contrast Media; Development; Digital Subtraction Angiography; Disease; Economic Burden; Evaluation; Four-dimensional; Goals; Gold; Image; Imaging Device; Individual; Ischemic Stroke; Knowledge; Label; Magnetic Resonance Imaging; Maps; Measures; Methods; Moyamoya Disease; Operative Surgical Procedures; Outcome; Patient Care; Patients; Pattern; Performance; Perfusion; Perioperative; Phase; Physiologic pulse; Postoperative Complications; Postoperative Period; Quantitative Evaluations; Radial; Resolution; Resources; Risk; Scanning; Spin Labels; Standardization; Techniques; Territoriality; Time; Tissues; base; cerebral hemodynamics; clinical imaging; clinical practice; design; disability; feeding; flexibility; hemodynamics; imaging modality; improved; novel; perfusion imaging; predict clinical outcome; preservation; prevent; quantitative imaging; reconstruction; revascularization surgery; spatiotemporal; stroke risk

PROJECT SUMMARY/ABSTRACT Cerebrovascular disease is one of the leading causes of death and disability worldwide. Cerebral revascularization, especially surgical revascularization, has evolved as an effective surgical therapy for the management of chronic cerebrovascular diseases such as moyamoya disease, complex aneurysms, and selected carotid steno-occlusive disease to improve the cerebral hemodynamics and reduce the risk of stroke. Nonetheless, optimal surgical planning is still unclear as a variety of revascularization techniques can be considered. To date, the choice of revascularization strategy is primarily based on the subjective interpretation of flow demands in the at-risk territory. This results in a variable, subjective clinical practice that places patients at risk for hemodynamics-related postoperative complications, significantly impacting the clinical outcomes. A segmented and quantitative characterization of cerebral hemodynamics pre- and post-revascularization is necessary to objectify flow requirements, standardize and improve patient care. However, none of the existing clinical imaging modalities are able to provide high spatiotemporal resolution angiographic images with quantitative hemodynamic information from individual arterial segments without contrast agents. Arterial spin labeling (ASL) possesses appealing features that allow for the assessment of both perfusion and angiography quantitatively. Building upon our successful track record on the development of ASL 4D MRA as well as ASL perfusion imaging, the goal of the present project is to develop and evaluate an easily-carry-out noninvasive ASL suite consisting of advanced 4D MRA and perfusion territorial mapping to quantitively assess cerebral hemodynamics from individual arteries and downstream tissue pre and post-cerebral revascularization. In Aim 1, we will develop and optimize a novel rapid high spatiotemporal resolution 4D MRA technique (<5minutes). In Aim2, we will develop and validate post-processing algorithms for cerebral hemodynamic quantification and vascular territories with 4D MRA and random vessel-encoded ASL. By leveraging the rich clinical resource from the USC Revascularization Center, in Aim 3, we will quantitively evaluate perioperative hemodynamics on patients who undergo cerebral revascularization and study the association of revascularization-related hemodynamic change with clinical outcomes. The successful completion of this project will lead to a robust, noninvasive, flexible, and quantitative ASL MRI suite within 10 min scan time that is ready to be incorporated into clinical MRI settings. The proposed technique can be highly valuable as a potential imaging tool for the quantitative evaluation of flow demands in cerebral revascularization.

项目摘要/摘要 脑血管疾病是全球死亡和残疾的主要原因之一。大脑 血运重建，尤其是手术血运重建，已成为一种有效的外科手术疗法 治疗慢性脑血管疾病，例如莫亚马亚病，复杂的动脉瘤和 选定的颈动脉steno-钙化疾病以改善脑血液动力学并降低中风的风险。 尽管如此，最佳手术计划仍不清楚，因为各种血运重建技术可以是 经过考虑的。迄今为止，血运重建策略的选择主要基于主观解释 处于风险领土的流量需求。这导致了可变的主观临床实践，使患者置于 与血液动力学相关的术后并发症的风险显着影响临床结果。一个 脑血液动力学前后重新血管的细分和定量表征是 客观化流量要求，标准化和改善患者护理所需的必要条件。但是，没有一个现有的 临床成像方式能够提供高时空分辨率血管造影图像 来自没有对比剂的单个动脉片段的定量血流动力学信息。动脉旋转 标签（ASL）具有吸引人的特征，可以评估灌注和血管造影 定量。在我们成功开发ASL 4D MRA以及ASL的成功记录的基础上 灌注成像，本项目的目标是开发和评估易于携带的无创ASL 由高级4D MRA和灌注领土映射组成的套件，用于定量评估脑 来自单个动脉和下游组织前和脑血运重建的血液动力学。目标 1，我们将开发并优化一种新型的快速高时空分辨率4D MRA技术（<5分钟）。在 AIM2，我们将开发和验证用于脑血液动力学定量和的后处理算法 具有4D MRA和随机血管编码ASL的血管区域。通过利用丰富的临床资源 在AIM 3中，USC血运重建中心将定量评估围手术期的血液动力学 经历脑血运重建并研究与血运重建有关的患者 血液动力学变化随临床结局。该项目的成功完成将导致强大的 无创，柔性和定量ASL MRI Suite在10分钟内准备合并的扫描时间内 进入临床M​​RI设置。提出的技术可能是作为潜在的成像工具的高价 脑血运重建中流量需求的定量评估。