MRI of Diabetic Retinopathy

糖尿病视网膜病变的 MRI

• 批准号: 10391756
• 负责人: Timothy Q. Duong
• 金额: $ 15.82万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10391756
• 关键词: MRI; Diabetic; Retinopathy

Diabetic retinopathy (DR) is the leading cause of blindness in working-age adults and occurs in about 45% of diabetic patients. DR is often diagnosed by late manifestations of the disease, such as blurred vision and abnormal appearance of the fundus. By the time a clinical diagnosis is made, vision loss or blindness is often the inevitable outcome. Results from clinical trials have documented that strict glycemic control in the early stages of diabetes is effective in reducing the risk of DR. Thus, early identification of diabetic individuals who are at risk of DR will enable timely intervention to minimize the risk of vision loss. The retina consists of three major cell layers (photoreceptor, bipolar, and ganglion) and two vascular (retinal and choroidal) layers bounding the retina, each of which is affected differently by DR. Our laboratory has pioneered innovative layer-specific blood-flow and functional MRI techniques based on echo-planar imaging at ~80x80x1000 µm. Echo-planar imaging of the eye suffers from susceptibility artifacts and image blurring, which precludes the earliest and most reliable DR detection. Moreover, although fluorescein angiography is widely used for visualization of vessels and diagnosis of DR, it does not have layer resolution and fluorescein (an optical contrast agent) can cause severe negative reactions, especially in diabetics who often have compromised renal function. Alternative approaches that can provide vascular layer resolution without needing a contrast agent will also have important clinical significance. We have recently explored non-echo-planar imaging approaches to study the retina. Our preliminary data show that balanced steady-state free precession (bSSFP) MRI provides markedly improved image quality and spatial resolution for blood-flow and functional MRI, and that MR angiography (MRA) provides layer-specific retinal and choroid vessels in the rat retina without using a contrast agent. In this proposal, we aim: i) to further develop bSSFP and MRA methods to study the rat retina with laminar specificity without using a contrast agent, ii) to evaluate these approaches to detect the earliest changes in retina of streptozotocin-induced diabetes, and iii) to test the hypothesis that strict glycemic control reverses these very early pre-vision loss manifestations of retinal changes in diabetes. Our central hypothesis is that abnormal retinal and choroidal blood flow and neurovascular coupling in the early pre-clinical stage of retinal changes in diabetes are detectable by these novel MRI methods prior to anatomic changes, and are reversed by strict glycemic control.

糖尿病视网膜病变 (DR) 是工作年龄成年人失明的主要原因，大约发生在 45% 的糖尿病患者通常是通过疾病的晚期表现来诊断的，例如视力模糊。 当做出临床诊断时，视力丧失或失明。 临床试验的结果证明，严格的血糖控制通常是不可避免的结果。 糖尿病的早期阶段可有效降低糖尿病患者的风险。 有 DR 风险的人将能够及时进行干预，以尽量减少视力丧失的风险。 视网膜由三个主要细胞层（感光细胞层、双极细胞层和神经节细胞层）和两个血管层组成 视网膜周围的（视网膜和脉络膜）层，每一层都受到 DR 的不同影响。 开创了基于回波平面的创新层特异性血流和功能 MRI 技术 眼睛的回波平面成像在 ~80x80x1000 µm 处成像会受到磁化率伪影和图像的影响。 模糊，这妨碍了最早和最可靠的 DR 检测。 血管造影广泛用于血管可视化和 DR 诊断，它没有分层分辨率 和荧光素（一种光学造影剂）会引起严重的负面反应，尤其是对于糖尿病患者 可以提供血管层分辨率的替代方法通常会损害肾功能。 无需造影剂也将具有重要的临床意义。 我们最近探索了非回声平面成像方法来研究视网膜。 表明平衡状态自由进动 (bSSFP) MRI 显着提高了图像质量 血流和功能 MRI 的空间分辨率，MR 血管造影 (MRA) 提供层特定 在不使用造影剂的情况下观察大鼠视网膜中的视网膜和脉络膜血管在该提案中，我们的目标是：i) 进一步。 开发 bSSFP 和 MRA 方法，在不使用对比的情况下研究具有层状特异性的大鼠视网膜 剂，ii) 评估这些方法以检测链脲佐菌素引起的视网膜的最早变化 糖尿病，以及 iii) 检验严格的血糖控制可以逆转这些早期视力丧失的假设 我们的中心假设是糖尿病视网膜变化的表现。 糖尿病视网膜变化早期临床前阶段的血流和神经血管耦合 这些新的 MRI 方法可以在解剖变化之前检测到，并通过严格的血糖控制来逆转。

项目成果

Retinal Vascular and Anatomical Features in the Spontaneously Hypertensive Rat.

自发性高血压大鼠的视网膜血管和解剖学特征。

• 发表时间: 2020
• 影响因子: 2
• 作者: Li, Yunxia;Wang, Qian;Muir, Eric R;Kiel, Jeffrey W;Duong, Timothy Q
• 通讯作者: Duong, Timothy Q