Nonenhanced 3T QISS MR Angiography of the Peripheral Arteries

非增强 3T QISS MR 外周动脉血管造影

• 批准号: 9766368
• 负责人: Robert R. Edelman
• 金额: $ 38.91万
• 依托单位: NORTHSHORE UNIVERSITY HEALTHSYSTEM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9766368
• 关键词: Address; Affect; Age; Angiography; Aorta; Arrhythmia; Arteries; Atherosclerosis; Atrial Fibrillation; Blood; Blood Vessels; Cause of Death; Cessation of life; Clinical; Contrast Media; Cost Savings; Country; Development; Diabetes Mellitus; Diagnosis; Diagnostic; Digital Subtraction Angiography; Disease Management; Distal; Elderly; Electrocardiogram; Ensure; Frequencies; Funding; Hip Prosthesis; Image; Image Analysis; Impaired Renal Function; Impairment; Implant; Incidence; Income; Institution; Intervention; Iodine; Kidney; Kidney Diseases; Laboratories; Magnetism; Metals; Modality; Morphologic artifacts; Noise; Patient-Focused Outcomes; Patients; Performance; Peripheral; Peripheral arterial disease; Phase; Physiologic pulse; Predisposition; Prevalence; Reference Standards; Renal function; Research; Risk; Roentgen Rays; Safety; Scanning; Services; Signal Transduction; Site; Slice; Specialist; Surgeon; Techniques; Testing; Time; United States National Institutes of Health; Vascular calcification; absorption; accurate diagnosis; base; calcification; cardiovascular risk factor; contrast enhanced; cost; cost effectiveness; diabetic patient; diagnostic accuracy; foot; functional disability; high risk; improved; innovation; low income country; metallicity; mortality risk; novel strategies; older patient; prognostic; public health relevance; radio frequency; research study; treatment strategy

 DESCRIPTION (provided by applicant): Peripheral arterial disease (PAD) is a potentially debilitating manifestation of systemic atherosclerosis affecting more than 200 million people worldwide. Accurate diagnosis is important for managing the disease and confers useful prognostic information. CT angiography (CTA) has become the preferred modality of vascular surgeons for the imaging evaluation of PAD, because of its simplicity and widespread availability. However, in addition to unwanted x-ray exposure from CTA, there is a nearly 40% prevalence of impaired renal function in patients with PAD. In such patients, iodine-based CT contrast agents pose a risk for contrast-induced nephropathy. As a result of efforts previously funded under NIH 1R01HL096916, the QISS nonenhanced MRA (NEMRA) technique was developed as a safer, simple "push button" nonenhanced alternative to CTA and contrast- enhanced MRA (CEMRA). However, no NEMRA technique has yet proven effective at 3 Tesla, which is widely considered the optimal field strength for CEMRA. In order to take advantage of the large signal-to-noise boost at 3 Tesla, severe image quality limitations relating to high specific absorption rate (SAR) and worsened B1 field homogeneity need to be overcome. This project aims to solve these challenges. It will improve patient outcomes by providing optimal selection of interventional treatment strategies irrespective of patient age, presence of diabetes, arrhythmia, metallic implants, or renal functional impairment. Moreover, it will greatly improve the safety profile of the imaging examination and avoid the need for renal function testing. This five-year project consists of an initial two-year technical development and optimization phase, followed by a two-site research study that will validate and ascertain the relative utility of 3T QISS MRA and peripheral CTA for the diagnosis and interventional management of PAD. Our specific aims are as follows: 1. To develop QISS techniques that are insensitive to magnetic susceptibility artifacts and B1 field inhomogeneity, and are optimized for the higher specific absorption rates encountered at 3 Tesla. These techniques will be evaluated in realistic flow phantoms, healthy subjects and patients with PAD. 2. To reduce the scan time for a complete QISS peripheral arterial study to less than five minutes so as to optimize procedural efficiency and patient comfort, while maintaining image quality and accuracy. 3. To develop ungated QISS techniques which match the image quality of ECG-gated QISS MRA. 4. To compare the diagnostic accuracy of QISS MRA at 3 Tesla (using techniques developed in Aims 1 and 2) for PAD compared with CTA, using digital subtraction angiography as the reference standard. A subsidiary aim is to compare UnQISS (developed in Aim 3) with CTA in patients with atrial fibrillation.

 描述（由申请人提供）：外周动脉疾病（PAD）是系统性动脉粥样硬化的一种潜在的衰弱表现，影响着全世界超过 2 亿人，准确的诊断对于控制该疾病非常重要，并且 CT 血管造影（CTA）已成为提供有用的预后信息。由于其简单性和广泛可用性，血管外科医生首选的 PAD 成像评估方式然而，除了 CTA 产生的不必要的 X 射线暴露之外， PAD 患者中有近 40% 的肾功能受损，基于 NIH 1R01HL096916 的 QISS 非增强 MRA 的研究结果表明，基于碘的 CT 造影剂会带来造影剂肾病的风险。 NEMRA）技术是作为 CTA 和对比增强 MRA (CEMRA) 的更安全、简单的“按钮”非增强替代方案而开发的。 NEMRA 技术在 3 特斯拉时已被证明是有效的，这被广泛认为是 CEMRA 的最佳场强。为了利用 3 特斯拉时的大信噪比提升，与高比吸收率相关的严重图像质量限制（ SAR）和恶化的 B1 场均匀性需要克服，该项目旨在解决这些挑战，无论患者年龄、是否患有糖尿病、 此外，它将大大提高影像检查的安全性，并避免进行肾功能测试。这个为期五年的项目包括最初的两年技术开发和优化阶段。随后进行一项两中心研究，将验证和确定 3T QISS MRA 和外周 CTA 在 PAD 诊断和介入治疗中的相对效用： 1. 开发对 PAD 不敏感的 QISS 技术。磁化率伪影和 B1 场不均匀性，并针对 3 特斯拉遇到的较高比吸收率进行了优化。这些技术将在真实的流动模型、健康受试者和 PAD 患者中进行评估 2. 减少完整 QISS 的扫描时间。外周动脉研究时间不超过五分钟，以优化程序效率和患者舒适度，同时保持图像质量和准确性 3. 开发与心电图门控 QISS 图像质量相匹配的非门控 QISS 技术。 MRA。 4. 使用数字减影血管造影作为参考标准，比较 QISS MRA（使用目标 1 和 2 中开发的技术）对 PAD 的诊断准确性。目标 3) 对心房颤动患者进行 CTA。

项目成果

High-resolution, non-contrast-enhanced magnetic resonance angiography of the wrist, hand and digital arteries using optimized implementation of Cartesian quiescent interval slice selective (QISS) at 1.5 T.

• DOI: 10.1016/j.mri.2021.02.008
• 发表时间: 2021-05
• 期刊: Magnetic resonance imaging
• 影响因子: 2.5
• 作者: Salehi Ravesh M;Lebenatus A;Bonietzki A;Hensler J;Koktzoglou I;Edelman RR;Graessner J;Jansen O;Both M
• 通讯作者: Both M

Free-Breathing Fast Low-Angle Shot Quiescent-Interval Slice-Selective Magnetic Resonance Angiography for Improved Detection of Vascular Stenoses in the Pelvis and Abdomen: Technical Development.

自由呼吸快速低角度拍摄静态间隔切片选择性磁共振血管造影用于改进骨盆和腹部血管狭窄的检测：技术开发。

• DOI: 10.1097/rli.0000000000000592
• 发表时间: 2019
• 期刊: Investigative radiology
• 影响因子: 6.7
• 作者: Varga-Szemes,Akos;Aherne,EmilyA;Schoepf,UJoseph;Todoran,ThomasM;Koktzoglou,Ioannis;Edelman,RobertR
• 通讯作者: Edelman,RobertR

Evaluation of Lower Leg Arteries and Fibular Perforators before Microsurgical Fibular Transfer Using Noncontrast-Enhanced Quiescent-Interval Slice-Selective (QISS) Magnetic Resonance Angiography.

• DOI: 10.3390/jcm12041634
• 发表时间: 2023-02-18
• 期刊: Journal of clinical medicine
• 影响因子: 3.9

Diagnostic accuracy of non-contrast quiescent-interval slice-selective (QISS) MRA combined with MRI-based vascular calcification visualization for the assessment of arterial stenosis in patients with lower extremity peripheral artery disease.

• DOI: 10.1007/s00330-020-07386-4
• 发表时间: 2021-05
• 期刊: European radiology
• 影响因子: 5.9
• 作者: Varga-Szemes A;Penmetsa M;Emrich T;Todoran TM;Suranyi P;Fuller SR;Edelman RR;Koktzoglou I;Schoepf UJ
• 通讯作者: Schoepf UJ