Volumetric MRSI Evaluation of Traumatic Brain Injury

创伤性脑损伤的体积 MRSI 评估

• 批准号: 7215621
• 负责人: Andrew A. Maudsley
• 金额: $ 26.73万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7215621
• 关键词: Brain; Brain Edema; Brain Injuries; Brain Stem; Brain region; Choline; Clinical; Clinical assessments; Corpus Callosum; Detection; Development; Diffuse; Diffuse Brain Injury; Disruption; Evaluation; Gray unit of radiation dose; Head; Histocompatibility Testing; Image; Image Analysis; Individual; Injury; Lobe; Localized; Location; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Measurement; Measures; Membrane; Metabolic; Metabolic Marker; Metabolism; Methods; N-acetylaspartate; Neuronal Dysfunction; Neuropsychological Tests; Normal Range; Outcome; Patients; Phase; Pilot Projects; Pontine structure; Process; Protons; Public Health; Research; Research Personnel; Score; Severities; Signal Transduction; Statistical Methods; Testing; Time; Tissues; Traumatic Brain Injury; Water; base; brain metabolism; computerized data processing; density; expectation; experience; functional outcomes; image processing; improved; neuroimaging; spectroscopic imaging; white matter

DESCRIPTION (provided by applicant): The long-term objective of this project is improved evaluation of Traumatic Brain Injury (TBI) using advanced MR neuroimaging methods. TBI represents a major public health problem for which there are currently no objective measures that are able to quantify the severity of injury, or to indicate possible outcomes. Previous studies have shown that Magnetic Resonance Spectroscopy can detect widespread metabolic changes in the brain that correlate with the degree of injury, even in the absence of significant MRI findings. For mild TBI subjects, which represents the largest group of these patients and the most difficult to evaluate, these diffuse metabolic abnormalities may be small in magnitude, though widespread, while it is also known that some brain regions are more susceptible to injury and may have more focal abnormalities, particularly with more severe injury. Therefore, it is hypothesized that improved characterization of this type of brain injury will be obtained by using a) improved detection sensitivity and acquisition from a wide region of the brain, and b) analysis of both focal and diffuse multiparametric metabolic abnormalities, in comparison with normal values. This pilot study will use volumetric proton MR Spectroscopic Imaging (MRSI) at 3 Tesla using phased-array detection, for characterization of metabolic changes associated with mild and moderate closed-head TBI. Measurements will include N-Acetylaspartate and choline, metabolic markers known to be sensitive to neuronal dysfunction and membrane turnover. Results will be correlated with findings from structural MRI, initial clinical assessments, and outcome evaluations, including results of neuropsychological testing. MRSI processing methods will incorporate MRI information to enable metabolite analysis by brain region and tissue type, as well as voxel-based comparisons with normal values. Quantitative neuroimaging measures will be developed that will characterize: 1) which brain locations experience greatest MR-detected metabolic and structural changes; 2) the spatial extent and the degree of metabolic alteration; and 3) which clinical and MR imaging measures best correlate with clinical outcome at 6 months post injury. It is hypothesized that the improved sensitivity and spatial coverage of the spectroscopic measurement and analysis methods will enable improved characterization of mild and moderate injury, and that the metabolic neuroimaging methods will be more sensitive than MRI for evaluation of this brain injury. Relevance of this research: Improved imaging assessment of metabolic changes associated with diffuse brain injury will guide treatment and patient management decisions following brain trauma, as well as providing expectations for long-term consequences of the injury.

描述（由申请人提供）：该项目的长期目标是使用先进的 MR 神经影像方法改进对创伤性脑损伤 (TBI) 的评估。 TBI 是一个重大的公共卫生问题，目前还没有客观的措施能够量化伤害的严重程度或表明可能的结果。先前的研究表明，即使没有显着的 MRI 结果，磁共振波谱也可以检测到大脑中与损伤程度相关的广泛代谢变化。对于轻度 TBI 受试者来说，这些受试者代表了这些患者中最大的群体，也是最难评估的，这些弥漫性代谢异常虽然广泛，但幅度可能很小，同时众所周知，某些大脑区域更容易受到损伤，并且可能有更多局灶性异常，尤其是损伤更严重时。因此，假设与传统方法相比，通过使用a）改进的检测灵敏度和从大脑的广泛区域获取数据，b）对局灶性和弥漫性多参数代谢异常进行分析，可以改善对此类脑损伤的表征。正常值。该试点研究将使用 3 特斯拉体积质子 MR 光谱成像 (MRSI)，并采用相控阵检测，来表征与轻度和中度闭头 TBI 相关的代谢变化。测量包括 N-乙酰天冬氨酸和胆碱，这些代谢标记物已知对神经元功能障碍和膜周转敏感。结果将与结构 MRI 的结果、初始临床评估和结果评估（包括神经心理学测试的结果）相关联。 MRSI 处理方法将结合 MRI 信息，以便能够按大脑区域和组织类型进行代谢物分析，以及与正常值进行基于体素的比较。将开发定量神经影像测量方法，以表征：1）哪些大脑位置经历了 MR 检测到的最大代谢和结构变化； 2）空间范围和代谢改变的程度； 3) 哪些临床和 MR 成像测量与损伤后 6 个月的临床结果最相关。据推测，光谱测量和分析方法的灵敏度和空间覆盖范围的提高将能够改善轻度和中度损伤的表征，并且代谢神经成像方法在评估这种脑损伤方面将比 MRI 更敏感。这项研究的相关性：改进与弥漫性脑损伤相关的代谢变化的成像评估将指导脑外伤后的治疗和患者管理决策，并为损伤的长期后果提供预期。