Non-Contrast Magnetic Resonance Angiography of Peripheral Vascular Disease

周围血管疾病的非对比磁共振血管造影

• 批准号: 8402153
• 负责人: Robert R. Edelman
• 金额: $ 44.61万
• 依托单位: NORTHSHORE UNIVERSITY HEALTHSYSTEM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8402153
• 关键词: Affect; Angiography; Arrhythmia; Arteries; Atrial Fibrillation; Blood; Blood Vessels; Blood flow; Caliber; Cardiac; Cardiovascular system; Cine Magnetic Resonance Imaging; Clinical; Clinical Trials; Contrast Media; Dependence; Diagnosis; Diagnostic Imaging; Disease; Exercise; Fatty acid glycerol esters; Fibrosis; Goals; Health; Image; Impaired Renal Function; Kidney; Knowledge; Location; Magnetic Resonance Angiography; Methodology; Methods; Modeling; Morbidity - disease rate; Morphologic artifacts; Motion; Patients; Pattern; Pelvis; Peripheral; Peripheral Vascular Diseases; Physiologic pulse; Procedures; Pulsatile Flow; Recovery; Reporting; Resolution; Risk; Signal Transduction; Slice; Techniques; Technology; Testing; Thick; Time; Tissues; United States; base; cost; data acquisition; diagnostic accuracy; heart rhythm; image reconstruction; improved; mortality; new technology; novel strategies; patient safety; research study; simulation

DESCRIPTION (provided by applicant): Peripheral vascular disease (PVD) affects 8 million people in the United States, causes significant morbidity, and is associated with cardiovascular mortality. Given that many patients with PVD also suffer from impaired renal function, one must exercise caution in using CE-MRA because of concerns about the risks of nephrogenic systemic fibrosis (NSF), a serious and potentially lethal disorder. Recently, non-enhanced MRA techniques have been proposed to eliminate the risk of NSF. The overall goal of this proposal is to implement a methodology for non-contrast peripheral MRA that is insensitive to the timing of peak systolic flow; moreover, the technology should be fast, insensitive to patient motion, and accurate. For this purpose, we have implemented a novel approach consisting of a fat suppressed, single shot 2D saturation-recovery trueFISP (SR-TFI) pulse sequence. Although this approach for non-contrast MRA has not been previously reported, our initial clinical trials demonstrate excellent results even in the presence of severe PVD. The method does not require prior knowledge of flow patterns and eliminates the need for cine MRI to determine the timing of peak flow velocity, a requirement for FBI. Moreover, the method is less sensitive to patient motion than FBI and has proven robust for imaging of the pelvic arteries. For the small subset of patients in whom it is not possible to synchronize the data acquisition to the cardiac cycle (e.g. due to atrial fibrillation or other cardiac arrhythmias), we propose the use of ungated Ghost MRA. Ghost MRA uses the ghost artifacts generated by pulsatile flow to create an MRA with no signal contribution from background tissues. Our specific aims are: Specific Aim 1: To optimize multi-station flow-insensitive SR-TFI of the peripheral arteries with a total acquisition time < 10 minutes using spatial resolution on the order of 1-2 mm3. Specific Aim 2: To implement multi-station flow-dependent (Ghost) MRA of the peripheral arteries with an image acquisition time < 5 minutes per station using spatial resolution on the order of 1 mm. Specific Aim 3: Evaluate non-contrast MRA in comparison with CE-MRA and/or x-ray DSA in patients

描述（由申请人提供）：周围血管疾病 (PVD) 影响着美国 800 万人，导致严重的发病率，并与心血管死亡率相关。鉴于许多 PVD ​​患者还患有肾功能受损，因此在使用 CE-MRA 时必须谨慎，因为担心肾源性系统性纤维化 (NSF)（一种严重且可能致命的疾病）的风险。最近，非增强型 MRA 技术被提出来消除 NSF 风险。该提案的总体目标是实施一种对非造影外周 MRA 的方法，该方法对收缩期峰值流量的时间不敏感；此外，该技术应该快速、对患者运动不敏感并且准确。为此，我们实施了一种新颖的方法，其中包括脂肪抑制、单次 2D 饱和恢复 trueFISP (SR-TFI) 脉冲序列。尽管这种用于非造影 MRA 的方法以前没有报道过，但我们的初步临床试验表明，即使存在严重的 PVD，也能取得优异的结果。该方法不需要预先了解流动模式，并且不需要电影 MRI 来确定峰值流速的时间，而这是 FBI 的要求。此外，该方法对患者运动的敏感度低于 FBI，并且已被证明对于盆腔动脉成像来说是稳健的。对于一小部分无法将数据采集与心动周期同步的患者（例如由于房颤或其他心律失常），我们建议使用非门控 Ghost MRA。幽灵 MRA 使用脉动流产生的幽灵伪影来创建没有背景组织信号贡献的 MRA。 我们的具体目标是： 具体目标 1：使用 1-2 mm3 数量级的空间分辨率，优化外周动脉的多站流量不敏感 SR-TFI，总采集时间 < 10 分钟。 具体目标 2：使用 1 毫米量级的空间分辨率，实现外周动脉的多站血流相关（幽灵）MRA，每个站的图像采集时间 < 5 分钟。 具体目标 3：与 CE-MRA 和/或 X 射线 DSA 相比，评估患者的非造影 MRA

项目成果

Comparison of quiescent inflow single-shot and native space for nonenhanced peripheral MR angiography.

• DOI: 10.1002/jmri.24124
• 发表时间: 2013-12
• 期刊: JOURNAL OF MAGNETIC RESONANCE IMAGING
• 影响因子: 4.4
• 作者: Ward, Emily V.;Galizia, Mauricio S.;Usman, Asad;Popescu, Andrada R.;Dunkle, Eugene;Edelman, Robert R.
• 通讯作者: Edelman, Robert R.

Quiescent-interval single-shot unenhanced magnetic resonance angiography of peripheral vascular disease: Technical considerations and clinical feasibility.

• DOI: 10.1002/mrm.22287
• 发表时间: 2010-04
• 期刊: MAGNETIC RESONANCE IN MEDICINE
• 影响因子: 3.3
• 作者: Edelman, Robert R.;Sheehan, John J.;Dunkle, Eugene;Schindler, Nancy;Carr, James;Koktzoglou, Ioannis
• 通讯作者: Koktzoglou, Ioannis

Peripheral arterial disease in a symptomatic diabetic population: prospective comparison of rapid unenhanced MR angiography (MRA) with contrast-enhanced MRA.

• DOI: 10.2214/ajr.10.6091
• 发表时间: 2011-12
• 期刊: AJR. American journal of roentgenology
• 作者: Hodnett PA;Ward EV;Davarpanah AH;Scanlon TG;Collins JD;Glielmi CB;Bi X;Koktzoglou I;Gupta N;Carr JC;Edelman RR
• 通讯作者: Edelman RR

Ungated radial quiescent-inflow single-shot (UnQISS) magnetic resonance angiography using optimized azimuthal equidistant projections.

• DOI: 10.1002/mrm.25477
• 发表时间: 2014-12
• 期刊: MAGNETIC RESONANCE IN MEDICINE
• 影响因子: 3.3
• 作者: Edelman, Robert R.;Giri, Shivraman;Murphy, Ian G.;Flanagan, Oisin;Speier, Peter;Koktzoglou, Ioannis
• 通讯作者: Koktzoglou, Ioannis

Simultaneous static and cine nonenhanced MR angiography using radial sampling and highly constrained back projection reconstruction.

使用径向采样和高度约束的反投影重建同时进行静态和电影非增强 MR 血管造影。

• DOI: 10.1002/mrm.25008
• 发表时间: 2014
• 期刊: Magnetic resonance in medicine
• 影响因子: 3.3
• 作者: Koktzoglou,Ioannis;Mistretta,CharlesA;Giri,Shivraman;Dunkle,EugeneE;Amin,Parag;Edelman,RobertR
• 通讯作者: Edelman,RobertR