Improved Measurement of Cerebral Perfusion with MRI

改进 MRI 脑灌注测量

• 批准号: 7163558
• 负责人: TIMOTHY J CARROLL
• 金额: $ 32.48万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7163558
• 关键词: Acute; Affect; American; Animal Model; Blood Clot; Blood Vessels; Blood coagulation; Blood flow; Brain; Canis familiaris; Cause of Death; Cerebral hemisphere hemorrhage; Cerebrovascular Circulation; Cerebrum; Cessation of life; Chronic; Diagnosis; Diagnostic Procedure; Diffusion; Drops; Goals; Heart; Imaging Techniques; Infarction; Intracranial Hemorrhages; Ischemia; Ischemic Penumbra; Ischemic Stroke; Knowledge; Magnetic Resonance Imaging; Measurement; Methods; Modeling; Patients; Perfusion; Pharmacotherapy; Physiologic pulse; Pulse taking; Research; Risk; Stroke; Techniques; Testing; Tissues; Triage; Vascular Diseases; Weight; Work; acute stroke; base; disability; feeding; improved; neuron loss; novel; thrombolysis

DESCRIPTION (provided by applicant): The broad, long-term objective of this project is to improve the diagnosis and treatment of ischemic stroke patients. Ischemic stroke is the third leading cause of death and disability in the industrialized world. In the US alone, between 500,000 and 750,000 people are affected by stroke each year. In an ischemic stroke, a blood clot blocks a blood vessel feeding the brain. Acute ischemic stroke is treatable through the use of drug therapies that dissolve blood clots (thrombolysis). Thrombolysis has been shown to reduce the death and disability associated with stroke, but carries significant risk of devastating intracerebral hemorrhage (ICH), indicating the need for careful triage. Without a means to predict ICH, thrombolysis must be denied to over 90% of stroke patients. Evidence has shown that knowledge of CBF in ml/100g-min can help predict ICH in acute stroke patients. A major impediment in treatment of ischemic stroke is the lack of a widely available method for quantifying CBF for triage. This has prompted the American Heart and Stroke Association to recommend: "More research must be conducted to make these techniques, especially the MR-based methods, quantifiable". We have recently developed a novel MRI pulse sequence for quantitative CBF. We will validate this diagnostic technique in both animal models of ischemic stoke and in a patients with acute and chronic ischemia. We will show that qCBF can be used to risk stratify patients so that patients who would not normally be eligible for thrombolysis can be safely treated with this lifesaving therapy. The specific aims of this proposal are to test the following hypotheses: Specific Aim 1: MRI measurements of perfusion can accurately quantify CBF in normal canines. Specific Aim 2: MRI measurements of perfusion can accurately quantify CBF a canine model of ischemic stroke. Specific Aim 3: MRI measurements can predict CBF in chronic ischemic patients. Specific Aim 4: In acute stroke patients, quantitative CBF values can predict intracranial hemorrhage resulting from thrombolysis. Upon successful completion of this work we will have developed and validated a new MRI method that quantifies CBF for the triage of acute stroke patients.

描述（由申请人提供）：该项目的广泛长期目标是改善缺血性中风患者的诊断和治疗。缺血性中风是工业化世界中死亡和残疾的第三大主要原因。仅在美国，每年有500,000至750,000人受到中风的影响。在缺血性的中风中，血块阻塞了血管喂养大脑的血管。急性缺血性中风可以通过使用溶解血凝块的药物疗法（溶栓）来治疗。溶栓已被证明可以减少与中风相关的死亡和残疾，但具有毁灭性脑内出血（ICH）的显着风险，表明需要仔细分类。没有预测ICH的手段，必须拒绝超过90％的中风患者的溶栓。有证据表明，ML/100G MIN中CBF的知识可以帮助预测急性中风患者的ICH。缺血性中风治疗的主要障碍是缺乏可用于量化CBF分类的广泛可用的方法。这促使美国心脏和中风协会推荐：“必须进行更多的研究来制定这些技术，尤其是基于MR的方法，可量化”。我们最近开发了用于定量CBF的新型MRI脉冲序列。我们将在缺血性Stoke的动物模型以及急性和慢性缺血的患者中验证这种诊断技术。我们将证明QCBF可用于对患者进行分层的风险，以便通常不符合溶栓的患者可以通过这种救生治疗安全地治疗。该提案的具体目的是检验以下假设：特定目标1：灌注的MRI测量可以准确地量化正常犬类中的CBF。特定目标2：灌注的MRI测量值可以准确量化CBF的缺血性中风模型。特定目标3：MRI测量可以预测慢性缺血患者的CBF。特定目的4：在急性中风患者中，定量CBF值可以预测溶栓引起的颅内出血。成功完成这项工作后，我们将开发并验证了一种新的MRI方法，该方法量化了CBF的急性中风患者分类。