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（由应用提供）：周围动脉疾病（PAD）是系统性动脉粥样硬化的潜在使人衰弱的表现，影响了全球超过2亿人。准确的诊断对于管理疾病并赋予有用的预后信息很重要。 CT血管造影（CTA）已成为血管外科医生对PAD成像评估的首选方式，因为其简单性和宽度可用性。但是，除了从CTA接触不需要的X射线外，PAD患者的肾功能受损率近40％。在此类患者中，基于碘的CT对比剂构成对比引起的肾病的风险。由于先前根据NIH 1R01HL096916资助的努力，QISS非增强MRA（NEMRA）技术是作为一种更安全，简单的“按钮”非增强替代方案的CTA和对比度增强的MRA（CEMRA）。但是，尚无NEMRA技术在3特斯拉尚有证明是有效的，这被广泛认为是CEMRA的最佳田间强度。为了利用3特斯拉的大型信噪比，需要克服与高特异性滥用率（SAR）有关的严重图像质量限制，并且需要克服B1场均匀性。该项目旨在解决这些挑战。它将通过提供最佳的介入治疗策略来改善患者的预后，无论患者年龄，糖尿病的存在， 心律不齐，金属螺想症或肾功能障碍。此外，它将大大提高成像检查的安全性，并避免对肾功能测试的需求。这个五年的项目包括一个最初的两年技术开发和优化阶段，然后进行两次研究研究，该研究将验证和确定3T QISS MRA和外围CTA对PAD的诊断和介入管理的相对效用。我们的具体目的如下：1。开发对磁敏感性伪像和B1场不均匀性不敏感的QISS技术，并针对3特斯拉遇到的较高特异性滥用率进行了优化。这些技术将在现实的流幻象，健康受试者和PAD患者中进行评估。 2。将完整的QISS外围人工制品的扫描时间减少到不到五分钟，以优化程序效率和患者舒适性，同时保持图像质量和准确性。 3。开发未支配的QISS技术，以与ECG门控齐斯MRA的图像质量相匹配。 4。为了比较与CTA在3个Tesla（在AIMS 1和2中开发的技术）在与CTA相比，使用数字减法血管造影作为参考标准的诊断准确性（使用AIMS 1和2中开发的技术）。子公司的目的是将心房颤动患者的UNQISS（在AIM 3中开发）与CTA进行比较。

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