Quantitative cardiac MRI perfusion for longitudinal studies

用于纵向研究的定量心脏 MRI 灌注

• 批准号: 8373623
• 负责人: EDWARD VR DIBELLA
• 金额: $ 49.8万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8373623
• 关键词: Ablation; Animal Model; Area; Arrhythmia; Atrial Fibrillation; Blood; Blood flow; Cardiac; Cardiac ablation; Cardiology; Collaborations; Data; Data Analyses; Development; Diastole; Disease regression; Dose; Electrocardiogram; Estimation Techniques; Evaluation; Fibrosis; Financial compensation; Frequencies; Goals; Heart; Heart Atrium; Heart Diseases; Human; Image; Information Resources Management; Lead; Left; Left Atrial Function; Location; Longitudinal Studies; Magnetic Resonance Imaging; Maps; Measurement; Measures; Methodology; Methods; Microspheres; Monitor; Motion; Myocardial; Myocardial perfusion; Myocardium; Patients; Perfusion; Phase; Physiological; Play; Population; Positron-Emission Tomography; Process; Public Health; Quality of life; Radial; Radio; Recovery; Recurrence; Resolution; Risk; Role; Sampling; Signal Transduction; Sinus; Stroke; Systole; Techniques; Testing; Time; Tissues; Validation; Variant; Ventricular; Ventricular Remodeling; Work; base; blind; design; flexibility; heart function; heart motion; improved; insight; novel; reconstruction; research clinical testing; respiratory; response; spatiotemporal; success; tool

DESCRIPTION (provided by applicant): This work seeks to develop, evaluate and use new MRI methods for non-invasive quantitative assessment of myocardial perfusion reserve (MPR). The methods will be designed to work robustly for patients with arrhythmias or poor ECG signals. The methods will be applied along with left ventricular (LV) and left atrial (LA) function and LA fibrosis measurements to study changes due to treatment for atrial fibrillation (AF). Specific aims are (1) To design and test highly-undersampled ungated perfusion acquisitions and reconstructions. (2) To provide robust quantitative perfusion estimates by improved processing and by identifying an accurate arterial input function using methods that are widely applicable across a range of doses and acquisition types. (3) To determine the validity and repeatability of the proposed quantitative methods and the differences in perfusion and MPR measured at systole and diastole, including determining if systole or diastole is most repeatable when quantifying perfusion. (4) To determine the changes over time in perfusion reserve and cardiac function and left atrial fibrosis, after ablative treatment for AF. This will allow for determining the extent of perfusion improvement acutely due to conversion to sinus rhythm and the degree of recovery of perfusion reserve that recovers more slowly over months. These aims will be accomplished by developing methods to acquire perfusion data continuously, without a gating signal. Gating will be accomplished by analyzing the data retrospectively. Advanced reconstruction methods that include low rank and spatiotemporal constraints, and that employ compensation for respiratory and cardiac motion, will be developed and tested with the rapidly acquired self-gated perfusion sequences. An accurate arterial input function will be obtained using constrained data- driven blind estimation techniques. The accuracy of the new methods will be determined by validation in an animal model of AF, and by comparison to human studies with dynamic PET, and the repeatability of the methods will be characterized. The serial application of the methods to patients undergoing ablation therapy will then provide new information regarding changes associated with myocardial remodeling. The development and use of such accurate and repeatable measurements of perfusion in humans will accelerate evaluation of clinical therapies, and provide new tools and knowledge for the management of patients with cardiac disease. PUBLIC HEALTH RELEVANCE: This proposal offers new methods to quantify blood flow in the heart muscle in patients with arrhythmias or poor ECG signals in the MRI scanner. If such measurements can be made more accurate this will allow for better longitudinal studies that better inform treatments and monitoring of heart disease and will improve public health. The proposed methods will be applied along with measurements of heart function to patients with atrial fibrillation to improve their management and to improve our understanding of ablation treatment for atrial fibrillation.

描述（由申请人提供）：这项工作旨在开发，评估和使用新的MRI方法，用于对心肌灌注储备（MPR）的非侵入性定量评估。该方法将设计为为心律不齐或心电图信号差的患者稳健工作。该方法将与左心室（LV）和左心（LA）功能一起应用 和LA纤维化测量，以研究因心房颤动治疗而导致的变化（AF）。具体目的是（1）设计和测试高采样的未经灌注和重建。 （2）通过改进加工和使用在各种剂量和采集类型中广泛适用的方法来确定精确的动脉输入函数，通过改进处理和确定精确的动脉输入函数来提供强大的定量灌注估计。 （3）确定所提出的定量方法的有效性和可重复性以及在收缩和舒张期在灌注和MPR差异的差异，包括确定在量化灌注时是否最可重复进行基质或舒张期。 （4）确定灌注储备和心脏功能的随着时间的变化，并在消融治疗AF后留下心房纤维化。这将允许由于转化为鼻窦节奏和灌注储备的恢复程度，从而确定灌注的程度，在几个月内恢复了较慢。这些目标将通过开发无需门控信号的方法来连续获取灌注数据来实现。门控将通过回顾性分析数据来完成。包括低级和时空约束以及对呼吸和心脏运动的补偿的晚期重建方法将通过快速获得的自我门控灌注序列进行开发和测试。使用约束数据驱动的盲估算技术将获得准确的动脉输入函数。新方法的准确性将由AF动物模型中的验证确定，并且与动态PET的人类研究相比，该方法的可重复性将被表征。这些方法在接受消融疗法的患者中的序列应用将提供有关与心肌重塑相关的变化的新信息。这种准确且可重复的人类灌注测量的开发和使用将加速对临床疗法的评估，并为心脏病患者的管理提供新的工具和知识。 公共卫生相关性：该提案提供了量化心律不齐或MRI扫描仪心脏不良信号患者心肌血流的新方法。如果可以更准确地进行此类测量，这将允许更好地纵向研究，以更好地为治疗和监测心脏病，并改善公共卫生。所提出的方法将与心脏功能的测量一起应用于心房颤动的患者，以改善其管理，并提高我们对消融治疗房颤的理解。