Early to late gadolinium enhancement cardiac MRI in ischemic and non-ischemic cardiomyopathies

缺血性和非缺血性心肌病的早期至晚期钆增强心脏 MRI

• 批准号: 8968688
• 负责人: Taehoon Shin
• 金额: $ 19.19万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8968688
• 关键词: Acceleration; Algorithms; Amyloidosis; Area; Breathing; Cardiac; Cardiomyopathies; Cicatrix; Classification; Clinical; Clinical Research; Contrast Media; Contrast Sensitivity; Coronary Arteriosclerosis; Data; Defibrillators; Devices; Diagnosis; Dilated Cardiomyopathy; Dimensions; Doctor of Philosophy; Edema; Etiology; Evaluation; Face; Fibrosis; Four-dimensional; Gadolinium; Goals; Gold; Heart; Heart failure; Image; Image Analysis; Image Enhancement; Implant; Infarction; Injection of therapeutic agent; Injury; Kinetics; Learning; Link; Location; Magnetic Resonance Imaging; Measurement; Measures; Methods; Morbidity - disease rate; Morphologic artifacts; Motion; Myocardial; Myocardial Infarction; Myocardial Ischemia; Myocarditis; Myocardium; Outcome; Pathology; Patients; Pattern; Phase; Physiologic pulse; Physiological; Preparation; Prevalence; Primary idiopathic dilated cardiomyopathy; Process; Protocols documentation; Research; Resolution; Resources; Respiratory Diaphragm; Risk; Sarcoidosis; Scanning; Secondary to; Severities; Slice; Specificity; Techniques; Time; Tissues; Variant; Work; accurate diagnosis; base; gadolinium oxide; image reconstruction; imaging modality; improved; interdisciplinary collaboration; mortality; neglect; non-invasive imaging; novel; patient population; public health relevance; respiratory; temporal measurement; uptake

 DESCRIPTION (provided by applicant): In patients with heart failure (HF), accurate differentiation among ischemic and various non-ischemic cardiomyopathies (NICMs) is essential for appropriate guidance of therapies. Late gadolinium enhancement (LGE) MRI is an ideal non-invasive imaging method for depicting myocardial scarring and fibrosis, but is not well suitable for HF patients due to the requirement of many breath-holds and limited specificity to distinguish various forms of NICM. While LGE MRI is based on static analysis of the concentration of contrast agent at a single post-injection time, contrast uptake and washout is actually a temporally dynamic process, the pattern of which varies depending on specific pathological conditions. If accurately captured, the contrast kinetics may improve the tissue characterization particularly for differentiating NICMs that are associated with different etiologies. The ultimate goal of this project is to develop so-called early-to-late gadolinium enhancement (ELGE) MRI methods which capture contrast uptake and wash-out over time and to utilize the resultant kinetics information for differentiating various NICMs. Towards this goal, we will first develop respiratory motion corrected 3D LGE imaging methods which enable whole heart coverage during free-breathing. This will be achieved by integrating novel MRI components such as 3D stack-of-spirals acquisition, outer volume suppression magnetization preparation and 1D projection-based motion estimator. Then, ELGE measurement will be done in NICM patients by repeating the free-breathing scan between 1min through 40 min post injection. After parameterization of ELGE time curves, classification rules will be established to distinguish myocarditis, dilated cardiomyopathy and sarcoidosis that justify a larger clinical study.

 描述（由申请人提供）：对于心力衰竭 (HF) 患者，准确区分缺血性和各种非缺血性心肌病 (NICM) 对于适当指导治疗至关重要，晚期钆增强 (LGE) MRI 是一种理想的非侵入性治疗。成像方法用于描绘心肌疤痕和纤维化，但由于需要多次屏气且区分各种形式的心肌梗死的特异性有限，不太适合心力衰竭患者NICM。虽然 LGE MRI 基于单次注射后造影剂浓度的静态分析，但造影剂摄取和冲刷实际上是一个时间动态过程，其模式根据具体的病理条件而变化。对比动力学可以改善组织特征，特别是区分与不同病因相关的 NICM。该项目的最终目标是开发所谓的早期至晚期钆增强 (ELGE) MRI 方法。捕获随时间变化的造影剂摄取和清除，并利用所得的动力学信息来区分各种 NICM。为了实现这一目标，我们将首先开发呼吸运动校正的 3D LGE 成像方法，以实现自由呼吸期间的整个心脏覆盖。通过集成 3D 螺旋叠加采集、外部体积抑制磁化准备和基于 1D 投影的运动估计器等新颖的 MRI 组件，将对 NICM 患者进行 ELGE 测量。通过在注射后 1 分钟到 40 分钟之间重复自由呼吸扫描，在 ELGE 时间曲线参数化后，将建立分类规则来区分心肌炎、扩张型心肌病和结节病，从而证明更大规模的临床研究的合理性。