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.

推进围产期卒中的微观结构和血管神经影像学这项研究的总体目标是显着改善围产期的早期诊断和预后中风，以确定预后不良患者的最佳管理方案和治疗目标。磁共振成像 (MRI) 被认为是诊断和评估疾病的安全且灵敏的工具围产期中风以及快速发育的年轻大脑对这种损伤的反应。先进的核磁共振技术，特别是弥散室成像 (DCI)、磁化率加权 MRI (SWI) 和磁共振血管造影（MRA）被认为是临床成像方案的重要组成部分，用于评估中风和脑损伤。然而，这些技术在胎儿时期的应用极具挑战性，因为从小胎儿神经和血管结构以及间歇性胎儿和血管结构中获得的小信号母亲的运动会破坏这些通常很长的 MRI 扫描所需的空间编码。产后 MRI 提出了类似的挑战，特别是在头部的微小运动方面，这会产生显着的影响较长时间采集中的伪影。镇静剂用于固定婴儿和幼儿，侵入性和潜在有害；因此，不能用于研究。有一个迫切的需求，因此，需要运动稳健、高分辨率、先进的 MRI 技术来评估神经和神经血管胎儿和新生儿的结构。缺乏这种成像技术极大地限制了临床评估和预后，以及围产期卒中的研究。该项目旨在填补这些技术空白通过开发创新、运动稳健、高分辨率 MRI 序列，特别是 DCI、SWI、和MRA评估神经血管微观结构、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) 开发运动鲁棒 DCI 来评估围产期中风的大脑微结构和连接性改变； 2) 为SWI开发运动稳健技术对于胎儿和新生儿； 3) 为胎儿和新生儿开发运动稳健的 MRA。这些贡献很重要，因为它们将 1) 实现神经血管结构、大脑的体内高分辨率成像网络以及胎儿和新生儿大脑损伤； 2) 显着提高先进 MRI 的使用在临床和临床中评估围产期卒中和围产期卒中后大脑发育的技术在研究环境中。从这项研究中开发的技术和获得的知识将导致改进围产期卒中的诊断和预后，并将显着改善旨在减少围产期卒中的研究和试验通过及时治疗减轻脑瘫和癫痫等相关神经系统疾病的负担干预措施，即抗凝治疗、干细胞治疗、脑低温治疗、脑刺激和发展和教育疗法。