Volumetric MRSI Evaluation of Traumatic Brain Injury

创伤性脑损伤的体积 MRSI 评估

• 批准号: 7383756
• 负责人: Andrew A. Maudsley
• 金额: $ 26.74万
• 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 2009-01-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7383756
• 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

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.

该项目的长期目标是使用先进的对创伤性脑损伤（TBI）的评估 MR神经影像学方法。 TBI代表了一个主要的公共卫生问题，目前没有 能够量化伤害严重程度或指示可能结果的客观措施。以前的 研究表明，磁共振光谱可以检测到广泛的代谢变化 即使没有明显的MRI发现，与损伤程度相关的大脑也是如此。对于轻度TBI 这些受试者是这些患者中最大的组，也是最难评估的受试者，这些受试者散布 代谢异常可能很小，尽管很广泛，而也知道有些 大脑区域更容易受到伤害，可能具有更多的局灶性异常，尤其是更多 严重受伤。因此，假设这种类型的脑损伤的表征会改善 通过使用a）提高检测灵敏度和从大脑的广泛区域获得的获得，b） 与正常值相比，对局灶性和弥漫性多参数异常的分析。 这项试验研究将使用伪阵列使用体积质子MR光谱成像（MRSI）（MRSI） 检测，以表征与轻度和中度闭合头TBI相关的代谢变化。 测量将包括N-乙酰天冬氨酸和胆碱，代谢标记已知对 神经元功能障碍和膜更新。结果将与结构MRI的发现相关， 最初的临床评估和结果评估，包括神经心理学测试的结果。 MRSI 处理方法将纳入MRI信息，以实现大脑区域和组织的代谢物分析 类型以及基于体素的比较与正常值。定量神经成像措施将是 开发的将表征：1）哪些大脑位置经历了最大的MR-DETET代谢和 结构变化； 2）空间范围和代谢改变程度； 3）哪个临床和MR 受伤后6个月时，成像测量与临床结局相关。假设 光谱测量和分析方法的灵敏度和空间覆盖范围将提高 能够改善轻度和中度损伤的表征，并提出代谢神经影像学方法 对于评估这种脑损伤，将比MRI更敏感。 这项研究的相关性：改进与分散相关的代谢变化的成像评估 脑损伤将指导脑创伤后的治疗和患者管理决策 提供对伤害长期后果的期望。