Noninvasive Spinal Cord Perfusion Techniques with MRI

MRI 无创脊髓灌注技术

• 批准号: 10534733
• 负责人: MATTHEW D BUDDE
• 金额: $ 33.69万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10534733
• 关键词: Acute; Advocate; Affect; Animals; Biological Markers; Blood flow; Brain; Brain imaging; Caring; Clinical; Clinical Management; Contrast Media; Development; Diffusion; Diffusion Magnetic Resonance Imaging; Foundations; Future; Human; Image; Individual; Infusion procedures; Injury; Intervention; Life; Location; Magnetic Resonance Imaging; Measures; Medical; Methods; Modeling; Monitor; Neurological outcome; Outcome; Patient-Focused Outcomes; Perfusion; Perfusion Weighted MRI; Pre-Clinical Model; Predisposition; Quality of life; Rattus; Recommendation; Recovery; Reporting; Resolution; Risk; Rodent; Rodent Model; Role; Serial Magnetic Resonance Imaging; Severities; Specificity; Spinal Cord; Spinal Cord Contusions; Spinal cord injury; Spinal cord injury patients; Surgical Decompression; Systemic blood pressure; Techniques; Technology; Therapeutic; Thoracic spinal cord structure; Tissues; Translations; Traumatic injury; Treatment Efficacy; Visualization; acute care; arterial spin labeling; axon injury; clinical care; clinical translation; high resolution imaging; improved; in vivo; neurological recovery; non-invasive imaging; non-invasive monitor; novel; personalized care; personalized medicine; pharmacologic; predictive marker; pressure; public health relevance; restoration; risk prediction; severe injury; spinal cord imaging; therapeutic target; tool; translational study; treatment strategy

This proposal aims to establish perfusion magnetic resonance imaging (MRI) of the spinal cord as a translational tool and predictive biomarker of secondary damage after acute spinal cord injury (SCI). In SCI, minimizing damage that occurs beyond the initial insult (i.e. secondary injury) is considered a primary therapeutic target. Current clinical recommendations for acute SCI care advocate restoration of spinal cord perfusion to reduce secondary injury and provide the greatest chance for improved neurological outcome. However, spinal cord perfusion status is not routinely monitored in SCI patients, and the lack of noninvasive tools considerably impedes personalized care in SCI. Remarkably, while perfusion magnetic resonance imaging (MRI) of the brain has been reported in 100s of studies, there is almost a complete void of perfusion MRI studies applied to the spinal cord despite its high potential to improve patient outcomes. We previously showed that diffusion MRI of the rodent spinal cord, with contrast uniquely sensitized to axonal injury, could predict injury severity and neurological outcomes with high accuracy. With our recent advances in high resolution diffusion MRI, the location and extent of injury within the cord was visualized with detail in individual subjects. Thus, our central hypothesis is that while diffusion MRI detects irreversible injury acutely after SCI, perfusion MRI deficits reflect tissue at risk of secondary injury in the absence of an intervention. Our preliminary studies demonstrate the feasibility of obtaining high resolution perfusion MRI of the thoracic spinal cord. We propose to use in vivo MRI in a rat model of contusion SCI to (Aim 1) enhance and tailor perfusion MRI to the spinal cord for accurate, efficient, and high-resolution interrogation of perfusion status, (Aim 2) characterize perfusion and diffusion deficits after acute spinal cord traumatic injury in the rat to distinguish between reversible and non-reversible injury, and (Aim 3) demonstrate the utility of perfusion MRI to noninvasively monitor clinically-recommended interventions. Overall, these studies will provide a strong technical and scientific foundation to promote translational use of advanced MRI for personalized care of SCI patients. These translational studies aim to realize the full clinical utility of noninvasive imaging to maximize outcomes from such as devastating injury and its detrimental impact on quality-of-life.

该提案旨在建立脊髓灌注磁共振成像（MRI）作为 急性脊髓损伤（SCI）后继发性损伤的转化工具和预测生物标志物。在SCI中， 最大限度地减少初始侮辱之外发生的损害（即继发性伤害）被认为是主要的 治疗目标。当前急性 SCI 护理的临床建议主张脊髓修复 灌注以减少继发性损伤并为改善神经系统结果提供最大的机会。 然而，SCI 患者的脊髓灌注状态并未得到常规监测，而且缺乏无创性监测。 工具极大地阻碍了 SCI 的个性化护理。值得注意的是，虽然灌注磁共振 数百项研究报道了大脑成像（MRI），几乎完全没有灌注 尽管 MRI 研究具有改善患者预后的巨大潜力，但仍适用于脊髓。我们之前 研究表明，啮齿动物脊髓的扩散 MRI 与对轴突损伤特别敏感的对比剂，可以 高精度预测损伤严重程度和神经系统结果。随着我们最近在高 分辨率扩散 MRI，可在个体中详细显示脊髓内损伤的位置和程度 科目。因此，我们的中心假设是，虽然扩散 MRI 可以在 SCI 后迅速检测到不可逆损伤， 灌注 MRI 缺陷反映了在没有干预的情况下处于继发性损伤风险的组织。我们的 初步研究表明获得胸椎高分辨率灌注 MRI 的可行性 绳索。我们建议在挫伤性 SCI 大鼠模型中使用体内 MRI 来（目标 1）增强和调整灌注 对脊髓进行 MRI，以准确、高效和高分辨率地询问灌注状态（目标 2） 表征大鼠急性脊髓创伤性损伤后的灌注和扩散缺陷，以区分 可逆性和不可逆性损伤之间的区别，以及（目标 3）证明灌注 MRI 的实用性 无创监测临床推荐的干预措施。总体而言，这些研究将为 促进先进 MRI 转化用于 SCI 个性化护理的技术和科学基础 患者。这些转化研究旨在实现无创成像的全面临床应用，以最大限度地发挥作用。 毁灭性伤害等后果及其对生活质量的不利影响。

项目成果

Optimized cervical spinal cord perfusion MRI after traumatic injury in the rat.

大鼠创伤性损伤后优化颈脊髓灌注 MRI。

• 发表时间: 2021
• 作者: Meyer, Briana P;Hirschler, Lydiane;Lee, Seongtaek;Kurpad, Shekar N;Warnking, Jan M;Barbier, Emmanuel L;Budde, Matthew D
• 通讯作者: Budde, Matthew D

Relationships between spinal cord blood flow measured with flow-sensitive alternating inversion recovery (FAIR) and neurobehavioral outcomes in rat spinal cord injury.

使用流量敏感交替反转恢复 (FAIR) 测量的脊髓血流与大鼠脊髓损伤的神经行为结果之间的关系。

• 发表时间: 2021
• 影响因子: 2.5
• 作者: Lee, Seongtaek;Wilkins, Natasha;Schmit, Brian D;Kurpad, Shekar N;Budde, Matthew D
• 通讯作者: Budde, Matthew D

Differential Trajectory of Diffusion and Perfusion Magnetic Resonance Imaging of Rat Spinal Cord Injury.

大鼠脊髓损伤的扩散和灌注磁共振成像的差分轨迹。

• 发表时间: 2023-05
• 影响因子: 4.2
• 作者: Meyer, Briana P;Lee, Seung;Kurpad, Shekar N;Budde, Matthew D
• 通讯作者: Budde, Matthew D

Cervical spinal cord angiography and vessel-selective perfusion imaging in the rat.

大鼠颈髓血管造影和血管选择性灌注成像。

• 发表时间: 2024-02-14
• 影响因子: 2.9
• 作者: Lee, Seongtaek;Schmit, Brian D;Kurpad, Shekar N;Budde, Matthew D
• 通讯作者: Budde, Matthew D

Evolution of Magnetic Resonance Imaging as Predictors and Correlates of Functional Outcome after Spinal Cord Contusion Injury in the Rat.

磁共振成像作为大鼠脊髓挫伤后功能结果的预测因子和相关性的演变。

• 发表时间: 2020
• 影响因子: 4.2
• 作者: Wilkins, Natasha;Skinner, Nathan P;Motovylyak, Alice;Schmit, Brian D;Kurpad, Shekar;Budde, Matthew D
• 通讯作者: Budde, Matthew D