Advancing microstructural and vascular neuroimaging in perinatal stroke

推进围产期卒中的微观结构和血管神经影像学

基本信息

批准号：
10332741
负责人：
ALI GHOLIPOUR-BABOLI
金额：
$ 34.85万
依托单位：
BOSTON CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-02-15 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10332741
关键词：
Acute Address Adult Anticoagulant therapy Blood Vessels Brain Brain Injuries Brain Vascular Malformation Cephalic Cerebral Palsy Cerebrovascular Circulation Child Classification Clinic Clinical Clinical Trials Coagulation Process Complex Data Development Developmental Therapeutics Program Diagnosis Diffusion Diffusion Magnetic Resonance Imaging Early Diagnosis Edema Environment Epilepsy Evaluation Event Exposure to Fascicle Fetus Fiber Gold Growth Head Movements Hemorrhage High Prevalence Human Image Imaging Techniques Imaging technology Immobilization Impairment Infant Inflammation Injury Ionizing radiation Knowledge Life Link MRI Scans Magnetic Resonance Angiography Magnetic Resonance Imaging Maps Medical Imaging Methods Mission Modeling Morphologic artifacts Motion Nerve Degeneration Neurological outcome Newborn Infant Noise Outcome Patients Phlebography Predisposition Prognosis Property Protocols documentation Public Health Research Resolution Sampling Sedation procedure Signal Transduction Site Source Stroke Structure Techniques Technology Therapeutic Therapeutic Intervention Thrombus Time Ultrasonography United States National Institutes of Health Veins X-Ray Computed Tomography accurate diagnosis blood product brain abnormalities brain tissue cerebrovascular clinical imaging clinical prognosis density diagnosis evaluation disability fetal high resolution imaging image processing image reconstruction improved in vivo in vivo evaluation innovation ischemic lesion myelination natural hypothermia neonate nervous system disorder neuroimaging neuroprotection neurovascular perinatal brain perinatal stroke post stroke postnatal preventive intervention prospective relating to nervous system research clinical testing research study response spatiotemporal stem cell therapy therapeutic target tool vasogenic edema

项目摘要

Advancing microstructural and vascular neuroimaging in perinatal stroke The overall objective of this research is to dramatically improve early diagnosis and prognosis of perinatal stroke to identify the best management options and therapeutic targets for patients with a poor prognosis. Magnetic resonance imaging (MRI) is considered a safe and sensitive tool for the diagnosis and evaluation of perinatal stroke and the response of the rapidly growing young brain to this injury. Advanced MRI techniques, in particular, diffusion-compartment imaging (DCI), susceptibility-weighted MRI (SWI), and magnetic resonance angiography (MRA) are considered crucial components of a clinical imaging protocol to evaluate stroke and brain injury. The application of these techniques in the fetal period, however, is extremely challenging because of the small signal available from the small fetal neural and vascular structures and the intermittent fetal and maternal motion that disrupts the spatial encoding necessary for these typically lengthy MRI scans. Postnatal MRI poses similar challenges, particularly with respect to small head movements, which produce significant artifacts in longer acquisitions. Sedation, which is used to immobilize infants and very young children, is invasive and potentially harmful; and thus, cannot be used in research studies. There is a critical need, therefore, for motion-robust, high-resolution, advanced MRI technologies to evaluate neural and neurovascular structures in the fetus and neonate. The lack of such imaging technology significantly limits clinical evaluation and prognosis, as well as research on perinatal stroke. This project aims to fill these gaps in technology through the development of innovative, motion-robust, high-resolution MRI sequences, specifically, DCI, SWI, and MRA to evaluate neurovascular microstructure, cerebral vascular malformations, and brain network injury after perinatal stroke. The three specific aims of this project are to 1) develop motion robust DCI to evaluate altered brain microstructure and connectivity in perinatal stroke; 2) develop motion-robust technology for SWI for the fetus and newborn; and 3) develop motion-robust MRA for the fetus and newborn. These contributions are important because they will 1) enable in-vivo high-resolution imaging of the neurovascular structure, brain network, and injury in the fetal and newborn brain; and 2) significantly improve the use of advanced MRI technologies to assess perinatal stroke and brain development following perinatal stroke, both in the clinic and in research settings. The technology developed and knowledge obtained from this study will lead to improved diagnosis and prognosis of perinatal stroke, and will significantly improve studies and trials that aim to reduce the burden of related neurological disorders such as cerebral palsy and epilepsy through timely therapeutic interventions, i.e., anticoagulant therapy, stem cell therapies, brain hypothermia, brain stimulation, and developmental and educational therapies.

围产期中风中的微观结构和血管神经影像学这项研究的总体目的是显着改善围产期的早期诊断和预后中风以确定预后不良的患者的最佳管理选择和治疗靶标。磁共振成像（MRI）被认为是诊断和评估的安全敏感工具围产期中风和快速生长的年轻大脑对这种损伤的反应。高级MRI技术，特别是，扩散室成像（DCI），易感加权MRI（SWI）和磁共振血管造影（MRA）被认为是临床成像方案的关键组成部分，以评估中风和脑损伤。然而，在胎儿时期的应用是极具挑战来自小胎儿神经和血管结构以及间歇性胎儿的小信号孕产妇运动破坏了这些通常冗长的MRI扫描所需的空间编码。产后 MRI构成了类似的挑战，尤其是在小头运动方面，这会产生重要的挑战在更长的收购中进行工件。用来固定婴儿和非常小的孩子的镇静剂是侵入性和潜在有害；因此，不能在研究中使用。有急需的需求，因此，用于运动的高分辨率，高级MRI技术来评估神经和神经血管胎儿和新生儿的结构。缺乏这种成像技术显着限制了临床评估和预后以及围产期中风的研究。该项目旨在填补这些技术的空白通过开发创新的，动作的，高分辨率的MRI序列，特别是DCI，SWI，和MRA评估神经血管微结构，脑血管畸形和脑网络损伤围产期中风后。该项目的三个具体目标是1）开发运动强大的DCI来评估围产期中风的大脑微观结构和连通性改变； 2）为SWI开发运动合理技术对于胎儿和新生儿； 3）为胎儿和新生儿开发运动刺激性MRA。这些贡献很重要，因为它们会1）启用神经血管结构的体内高分辨率成像，大脑网络和胎儿和新生大脑的伤害； 2）显着改善了高级MRI的使用在诊所和在研究环境中。从这项研究中获得的技术和知识将导致改进围产期中风的诊断和预后，将显着改善旨在减少的研究和试验通过及时治疗的相关神经系统疾病的负担，例如脑瘫和癫痫干预措施，即抗凝治疗，干细胞疗法，脑体温过低，脑刺激和发展和教育疗法。