Non-invasive detection of heart transplant rejection with MRI

MRI 无创检测心脏移植排斥反应

• 批准号: 8627044
• 负责人: Neil Ranjan Chatterjee
• 金额: $ 4.77万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-03-01 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8627044
• 关键词: Address; Angiography; Arteries; Biophysics; Biopsy; Blood Volume; Blood capillaries; Blood flow; Cardiac; Caring; Cause of Death; Cerebrum; Chest Pain; Chronic; Complication; Contrast Media; Coronary Arteriosclerosis; Coronary artery; Development; Diagnosis; Diagnostic; Diffuse; Disease; Disease Marker; Early Diagnosis; Goals; Graft Rejection; Heart; Heart Transplantation; Hospitals; Image; Imaging Techniques; Immunosuppressive Agents; Infarction; Infection; Ischemia; Lead; Left; Link; Magnetic Resonance Imaging; Maps; Measurement; Measures; Methods; Modeling; Monitor; Monte Carlo Method; Myocardial; Myocardial perfusion; Myocardial tissue; Myocardium; Non-Invasive Cancer Detection; Operative Surgical Procedures; Outcome; Patient Care; Patients; Perfusion; Physiological; Population; Procedures; Reference Values; Relative (related person); Rest; Risk; Roentgen Rays; Scanning; Signal Transduction; Staging; Stenosis; Symptoms; Techniques; Testing; Therapeutic immunosuppression; Transplant Recipients; Transplantation; Ultrasonography; United States; Vascular Diseases; Water; Work; cancer risk; capillary; cost effective; early onset; experience; follow-up; healthy volunteer; heart allograft; heart innervation; improved; nerve supply; non-invasive imaging; novel; novel marker; public health relevance; screening; single photon emission computed tomography; success; tool

DESCRIPTION (provided by applicant): More than 2100 heart transplants are performed per year in the United States alone, and for patients receiving a heart transplant, cardiac allograft vasculopathy (CAV) is the leading cause of death. There is currently no non-invasive means to detect CAV at is earliest, most treatable stage. CAV is a unique disease that is characterized by diffuse concentric stenosis first of the microvasculature and then the coronary arteries that can lead to ischemia and small stellate infarcts. Because heart transplant patients lack innervation of the heart, they do not experience the chest pain usually associated with infarct allowing CAV to progress un- noticed. For this reason, screening diagnostic measures are particularly important in heart transplant patients. Currently, CAV is detected in its advanced stages with Xray-angiography or Intravasular Ultrasound (IVUS), but these are invasive procedures, and because they assess the coronary arteries instead of the microvasculature, CAV can often go undetected. We propose the development of two new MRI tools to assess changes in myocardial function that reflect early onset CAV: quantitative perfusion and quantitative blood volume. In the proposed work, we will develop these new sequences in healthy volunteers, validate them, and then apply them to the intended population of transplant recipients.

描述（由申请人提供）：仅在美国，每年进行2100多个心脏移植，对于接受心脏移植的患者，心脏同种异体移植血管病（CAV）是死亡的主要原因。目前，目前尚无最早可检测CAV的非侵入性手段。 CAV是一种独特的疾病，其特征是微脉管系统的弥漫性同心狭窄，然后是可导致缺血和小星状梗死的冠状动脉。因为心脏移植患者缺乏神经 心脏，他们没有经历通常与梗塞相关的胸痛，从而使CAV不注意到。因此，筛查诊断措施在心脏移植患者中尤为重要。当前，在其高级阶段以X射线 - 血管造影或检查后超声检查（IVU）检测到CAV，但这些是侵入性程序，并且由于它们评估冠状动脉而不是微脉管系统，因此CAV通常会未被发现。我们提出了两种新的MRI工具的开发，以评估反映早期发作CAV的心肌功能的变化：定量灌注和定量血容量。在拟议的工作中，我们将在健康志愿者中开发这些新序列，验证它们，然后将其应用于预期的移植受者中。