Dual-Venc 5D flow for Assessment of Congenital Heart Disease in Pediatrics

Dual-Venc 5D 流程用于评估儿科先天性心脏病

• 批准号: 10679809
• 负责人: Elizabeth Weiss
• 金额: $ 4.34万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679809
• 关键词: 3-Dimensional; 4D MRI; Acceleration; Address; Adult; Age; Anesthesia procedures; Arteries; Blood flow; Body Size; Breathing; Bypass; Cardiac; Case Study; Cessation of life; Child; Childhood; Circulation; Clinical; Complex; Complication; Data; Development; Diagnostic Imaging; Disease Progression; Doppler Echocardiography; Echocardiography; Electrocardiogram; Environment; Failure; Fontan Procedure; General Anesthesia; Goals; Heart; Heart Rate; Heart Transplantation; Imaging Techniques; Individual; Infant; Legal patent; Life; Live Birth; Lung; Magnetic Resonance Imaging; Measurement; Measures; Methods; Monitor; Noise; Operative Surgical Procedures; Patient Monitoring; Patients; Pattern; Pediatrics; Phase; Physicians; Physiology; Population; Procedures; Prospective Studies; Pulmonary Circulation; Pulmonary Vascular Resistance; Pulmonary artery structure; Pulsatile Flow; Radial; Reproducibility; Resolution; Respiration; Route; Running; Sampling; Scanning; Secondary to; Series; Single ventricle congenital heart disease; Techniques; Testing; Time; United States; Validation; Veins; Venous; Viscosity; Work; analysis pipeline; cardiac magnetic resonance imaging; cohort; congenital heart disorder; data acquisition; diagnostic tool; expiration; flexibility; heart function; hemodynamics; image reconstruction; imaging modality; improved; in vivo; middle age; novel; palliation; pediatric patients; pressure; reconstruction; recruit; respiratory; standard of care; temporal measurement; tool; 3-Dimensional; 4D MRI; Acceleration; Address; Adult; Age; Anesthesia procedures; Arteries; Blood flow; Body Size; Breathing; Bypass; Cardiac; Case Study; Cessation of life; Child; Childhood; Circulation; Clinical; Complex; Complication; Data; Development; Diagnostic Imaging; Disease Progression; Doppler Echocardiography; Echocardiography; Electrocardiogram; Environment; Failure; Fontan Procedure; General Anesthesia; Goals; Heart; Heart Rate; Heart Transplantation; Imaging Techniques; Individual; Infant; Legal patent; Life; Live Birth; Lung; Magnetic Resonance Imaging; Measurement; Measures; Methods; Monitor; Noise; Operative Surgical Procedures; Patient Monitoring; Patients; Pattern; Pediatrics; Phase; Physicians; Physiology; Population; Procedures; Prospective Studies; Pulmonary Circulation; Pulmonary Vascular Resistance; Pulmonary artery structure; Pulsatile Flow; Radial; Reproducibility; Resolution; Respiration; Route; Running; Sampling; Scanning; Secondary to; Series; Single ventricle congenital heart disease; Techniques; Testing; Time; United States; Validation; Veins; Venous; Viscosity; Work; analysis pipeline; cardiac magnetic resonance imaging; cohort; congenital heart disorder; data acquisition; diagnostic tool; expiration; flexibility; heart function; hemodynamics; image reconstruction; imaging modality; improved; in vivo; middle age; novel; palliation; pediatric patients; pressure; reconstruction; recruit; respiratory; standard of care; temporal measurement; tool

Project Abstract/Summary Congenital heart disease (CHO) afflicts up to 2% of live births in the United States. Among the most severe CHO is single ventricle disease (SVD) where infants are born with only one sufficiently functional ventricle. SVD often requires a series of surgeries that is completed with the Fontan procedure. This results in a circulation that bypasses a right-heart-driven pulmonary circulation, instead, routing systemic venous return directly to the pulmonary arteries. While it is a life-saving procedure, a common complication later in life is failing Fontan physiology which often results in heart transplant, initiation of palliation, or death. Despite regular monitoring of these patients, the underlying mechanisms leading to Fontan failure are poorly understood. Several modes of Fontan failure are hypothesized to be secondary to changes in 3D blood flow dynamics inside the Fontan connection. Current standard-of care imaging methods (echocardiography and 2D phase contrast MRI) capture only 1D hemodynamics and have substantial user variability. 4D flow MRI, a technique pioneered by our lab, was developed to address these challenges, and enable volumetric, 3D velocity measurement over the cardiac cycle. While this technique has been used to study Fontan hemodynamics, among other CHDs, it is not optimal for thorough, life-long monitoring. 4D flow has long, unpredictable scan times which are not amenable to small children requiring anesthesia during cardiac MRI studies. Additionally, 4D flow has a limited velocity dynamic range, lacks flexible reconstruction for different temporal and spatial resolution, and does not capture respiratory driven flow, a hemodynamic feature known to be important in the Fontan connection. To address these limitations, we have developed a method termed 5D flow MRI, a free-running technique with flexible, compressed sensing reconstruction that captures 3D velocities along the cardiac and respiratory cycles. The first aim of this proposal is to develop an under 10 minutes dual-velocity encode (venc) 5D flow method along with a streamlined processing and analysis pipeline. This will enable accurate, simultaneous measurement of flow in veins and arteries while remaining sufficiently short for patients requiring general anesthesia. The second aim of this proposal is to validate this method and to optimize the reconstruction and acquisition parameters. This will be crucial for understanding the reliability of the metrics compared to clinical standards and to ensure that respiratory resolved flow is accurate. The third aim of this proposal is to apply the developed sequence in a cohort of patients with the Fontan connection. I hypothesize that: 1. Dual-venc 5D flow will be faster and simpler than clinically standard acquisitions, 2. Respiratory resolved flow measurements reveal additional hemodynamic information, 3. Voxel-wise parameters derived from 5D flow, such as respiratory driven peak velocities, correlate with pulmonary vascular resistance, an invasive measurement.

项目摘要/摘要 在美国，先天性心脏病（CHO）最多可占活产2％。最严重的CHO是单个心室疾病（SVD），婴儿天生只有一个足够功能的心室。 SVD通常需要通过Fontan程序完成的一系列手术。这导致循环绕过右心脏驱动的肺循环，而是将系统性静脉恢复直接返回到肺动脉。虽然这是一种挽救生命的程序，但生命后来的常见并发症是Fontan生理失败，通常会导致心脏移植，抑制或死亡。尽管经常监测这些患者，但导致Fontan衰竭的基本机制知之甚少。 假设Fontan失败的几种模式是Fontan连接内3D血流动力学变化的继发性。当前的护理成像方法（超声心动图和2D相对比度MRI）仅捕获1D血液动力学，并且具有很大的用户变异性。 4D Flow MRI是我们实验室开发的一种技术来解决这些挑战，并在心脏周期中实现了体积的3D速度测量。尽管该技术已用于研究丰丹血流动力学，但它并不适用于彻底的终身监测。 4D流量具有长时间，不可预测的扫描时间，这对于在心脏MRI研究中需要麻醉的小孩不适合。此外，4D流的速度动态范围有限，缺乏针对不同的时间和空间分辨率的柔性重建，并且不会捕获呼吸驱动流动，这是Fontan连接中很重要的血液动力学特征。为了解决这些局限性，我们开发了一种称为5D流MRI的方法，该方法是一种具有柔性，压缩感测重建的自由运行技术，可捕获沿心脏和呼吸周期的3D速度。 该建议的第一个目的是开发10分钟以下的双速度编码（Venc）5D流量方法以及简化的处理和分析管道。这将实现准确的，同时测量静脉和动脉的流量，同时对需要全身麻醉的患者保持足够短的时间。该建议的第二个目的是验证该方法并优化重建和采集参数。这对于理解指标与临床标准相比的可靠性至关重要，并确保呼吸解析的流量准确。该提案的第三个目的是将开发的序列应用于具有丰丹连接的患者队列。我假设：1。双venc 5D流将比临床标准的收购更快，更简单，2。呼吸解析的流量测量结果揭示了其他血液动力学信息，3。源自5D流的体素参数，例如呼吸道驱动的峰值，例如峰值峰值，与肺动脉抗衡量相关。