Microvascular Measures of Perfusion in Stroke Recanalization

中风再通中灌注的微血管测量

基本信息

批准号：
8304317
负责人：
Michael E Moseley
金额：
$ 68.43万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-02-01 至 2014-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8304317
关键词：
Acute Agreement Angiography Animal Model Area Arteries Belief Blood Blood Vessels Blood Volume Blood capillaries Blood flow Bolus Infusion Brain Brain Injuries Brain Part Brain region Caring Cause of Death Cerebral Ischemia Cerebrovascular Circulation Cerebrovascular Disorders Cerebrum Cessation of life Circle of Willis Clinical Clinical assessments Contrast Media Core-Binding Factor Data Devices Diagnostic Diffusion Diffusion weighted imaging Digital Subtraction Angiography Echo-Planar Imaging Economic Burden Exhibits Funding Goals Gold Growth Hour Image Imaging Techniques Individual Infarction Injury Internal carotid artery structure Investigation Ischemic Stroke Kinetics Label Lead Light Magnetic Resonance Magnetic Resonance Imaging Maps Measurement Measures Mechanics Metabolic Methodology Methods Microcirculatory Bed Modality Morbidity - disease rate Morphologic artifacts Noise Outcome Output Oxygen Patients Perfusion Perfusion Weighted MRI Physiologic pulse Play Predisposition Procedures Process Property Prospective Studies Publishing Radiology Specialty Receiver Operator Characteristics Recruitment Activity Reperfusion Therapy Risk Role Severities Signal Transduction Spin Labels Stroke Surrogate Markers Symptoms Techniques Testing Thrombectomy Time Tissues Tracer Veins Venous Weight X-Ray Computed Tomography Xenon absorption acronyms acute stroke base blood flow measurement brain tissue capillary capillary bed clinically significant disability feeding follow-up hemodynamics improved interest middle cerebral artery patient population prognostic restoration social thrombolysis trait

Acute Agreement Angiography Animal Model Area Arteries Belief Blood Blood Vessels Blood Volume Blood capillaries Blood flow Bolus Infusion Brain Brain Injuries Brain Part Brain region Caring Cause of Death Cerebral Ischemia Cerebrovascular Circulation Cerebrovascular Disorders Cerebrum Cessation of life Circle of Willis Clinical Clinical assessments Contrast Media Core-Binding Factor Data Devices Diagnostic Diffusion Diffusion weighted imaging Digital Subtraction Angiography Echo-Planar Imaging Economic Burden Exhibits Funding Goals Gold Growth Hour Image Imaging Techniques Individual Infarction Injury Internal carotid artery structure Investigation Ischemic Stroke Kinetics Label Lead Light Magnetic Resonance Magnetic Resonance Imaging Maps Measurement Measures Mechanics Metabolic Methodology Methods Microcirculatory Bed Modality Morbidity - disease rate Morphologic artifacts Noise Outcome Output Oxygen Patients Perfusion Perfusion Weighted MRI Physiologic pulse Play Predisposition Procedures Process Property Prospective Studies Publishing Radiology Specialty Receiver Operator Characteristics Recruitment Activity Reperfusion Therapy Risk Role Severities Signal Transduction Spin Labels Stroke Surrogate Markers Symptoms Techniques Testing Thrombectomy Time Tissues Tracer Veins Venous Weight X-Ray Computed Tomography Xenon absorption acronyms acute stroke base blood flow measurement brain tissue capillary capillary bed clinically significant disability feeding follow-up hemodynamics improved interest middle cerebral artery patient population prognostic restoration social thrombolysis trait

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项目摘要

ABSTRACT. The recanalization of brain following ischemic stroke is the best means of recovering brain. However, restoration of flow is often accompanied by brain injury and tissue death. A reliable depiction of restoration of flow together with salvageable brain is of clinical significance. Imaging with MRI offers diagnostically useful depictions of stroke injury from T2, DWI, and perfusion imaging. However, we need improved methods of perfusion in order to best map and differentiate flow from tissue status. The clinical hypothesis that reperfusion of brain is a process of restoration of flow in the time window of salvaging brain, and being able to depict both aspects of that reperfusion process are crucial to the hundreds of reperfusion procedures done daily worldwide. The overall goal of this new submission is to identify and improve cerebral blood flow (CBF) techniques from dynamic susceptibility contrast (DSC) perfusion-weighted MRI (PWI) methods that can depict both restoration of flow together with the microvascular status that would optimally compare with DWI to form a clinically useful DWI-PWI mismatch representing brain tissue-at-risk or salvageable brain. To do this, we will assess the value of mapping perfusion with a gradient- echo (GRE) and a spin-echo (SE) signal acquired together in a multi-shot, multi- echo, and DSC first-pass bolus contrast agent MRI technique. The perfusion maps will be compared with a gold-standard xenon CT (xeCT) value of CBF. We aim to show equivalence between GRE- and SE-DSC to the gold-standard in order to visualize vascular and microvascular status in 120 stroke patients having had recanalization procedures. We will obtain T1, T2, T2*, diffusion-weighted imaging (DWI), and bolus PWI in 120 patients presenting at 6-48 hours following reperfusion and obtain a second follow-up study at 30 days as a measure of tissue outcome together with clinical assessments. We believe successful attainment of these aims promises to markedly improve acute stroke care by validating a MRI-based perfusion methods sensitive to both vascular status and tissue microvascular status. This study will lead to better understanding of mapping flow and microvascular status in patients with severe cerebrovascular disease and greatly enhance the already significant diagnostic power of MRI in acute ischemic stroke by better mapping metabolic- perfusion mismatches after reperfusion.

抽象的。脑部脑卒中后大脑的重新定性是最好的恢复大脑的手段。但是，流量的恢复通常伴随脑损伤和组织死亡。可靠地描绘流量的恢复可挽救的大脑具有临床意义。 MRI成像提供诊断有用的中风损伤的描述来自T2，DWI和灌注成像。但是，我们需要改进的方法灌注以最佳地图并区分组织状态。这临床假设，即大脑的再灌注是恢复流动的过程挽救大脑的时间窗口，并能够描绘这两个方面再灌注过程对于完成的数百种再灌注程序至关重要每天在全球。该新提交的总体目标是识别和改善脑来自动态敏感性对比（DSC）的血流（CBF）技术灌注加权MRI（PWI）方法，可以描绘出流量的恢复以及将与DWI最佳比较的微血管状态形成临床上有用的DWI-PWI不匹配，代表脑组织 - 风险或可挽救的大脑。为此，我们将评估用梯度映射灌注的价值 - 回声（GRE）和一个自旋回声（SE）信号一起以多拍的多弹 Echo和DSC第一通料对比剂MRI技术。灌注地图将与CBF的金标准氙CT（XECT）值进行比较。我们旨在显示Gre-和Se-DSC与金标准之间的等效性为了在120名中风患者中可视化血管和微血管状态采用了重新制定程序。我们将获得T1，T2，T2*，扩散加权成像（DWI）和PWI的120例患者，在6-48小时后出现再灌注并在30天后获得第二次随访研究作为量度结果以及临床评估。我们认为成功实现这些目标有望明显通过验证基于MRI的灌注方法敏感来改善急性中风护理均具有血管状态和组织微血管状态。这项研究将导致更好地了解映射流和微血管状态的患者严重的脑血管疾病，大大增强了已经很重要的 MRI在急性缺血性中风中的诊断能力通过更好地映射代谢 - 再灌注后灌注不匹配。