Development and Early Clinical Evaluation of Noninvasive MRI Measurement of ICP

无创 MRI 测量 ICP 的开发和早期临床评估

• 批准号: 7872132
• 负责人: NOAM ALPERIN
• 金额: $ 38.53万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-08 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7872132
• 关键词: Animal Model; Biomedical Engineering; Blood; Brain; Brain Edema; Cerebellar tonsil; Cerebrovascular Circulation; Clinical; Computer Simulation; Development; Diagnosis; Diagnostic; Disease; Functional disorder; Goals; Individual; Intracranial Pressure; Magnetic Resonance Imaging; Measurement; Measures; Methods; Monitor; Neurologic; Patients; Play; Radiology Specialty; Reproducibility; Risk; Role; Sampling; Scanning; Scheme; Spinal Canal; Techniques; Testing; Time; Validation; Weight; Work; base; blood flow measurement; brain tissue; cerebrospinal fluid flow; clinically relevant; data acquisition; healthy volunteer; improved; malformation; nervous system disorder; neurosurgery; nonhuman primate; novel; novel diagnostics; pressure; research clinical testing; tool

DESCRIPTION (provided by applicant): This bioengineering-radiology-neurosurgery partnership aims to further develop and test the clinical utility of a novel method for non-invasive measurement of intracranial compliance (ICC) and intracranial pressure (ICP). These important neurophysiologic parameters are measured using dynamic magnetic resonance imaging (MRI) of blood and cerebrospinal fluid (CSF) flows to and from the brain. The feasibility of this new technique is demonstrated using phantoms, computer simulations, non-human primate animal model, healthy volunteers, and small number of patients. Noninvasive quantification of these parameters is potentially important for improved diagnosis and treatment of several neurological problems. In this proposal we aim to demonstrate the potential clinical utility of a noninvasive ICC measurement to study a relatively common and poorly understood neurological problem, Chiari Malformations (CM) (associated with downward displacement of the cerebellar tonsils into the spinal canal). Some evidence suggests that ICC plays an important role in the pathophysiology of this disorder. However, because of increased risk of brain herniation associated with invasive ICC measurements in these patients, intracranial compliance has not been measured previously. Noninvasive ICC measurement in CM may help explain the pathophysiology and will potentially improve the diagnosis and treatment of this debilitating disorder. Moreover, since MRI is already used to diagnose CM, it would be practical to add the additional scan to obtain the ICC measurement noninvasively. While intracranial compliance quantifies the ability of the intracranial compartment to accommodate increase in volume (e.g., brain swelling) without a large increase in pressure, it is ICP that is more widely used clinically. Our MRI-based measurement of ICP relies on the inverse relationship between ICC and ICP. We propose further validations of a strong linear correlation we found between MR-ICP and invasively measured ICP in 9 patients. The proposed validations are an essential step before the method can become clinically acceptable and the potentially high diagnostic value of a noninvasive MR-ICP can be assessed in other neurological problems. The developmental components of the proposal aim at improving the MRI data acquisition scheme and at shortening overall scan time, primarily for increased measurement reliability by multiple sampling of ICP and for allowing dynamic measurements of ICP. The proposed developmental work also aims to improve measurements of total cerebral blood flow (tCBF), a byproduct of the MR-ICP measurement, by normalizing for the subject's total brain tissues volumes and weights. Preliminary results demonstrated lesser inter-individual variability of the normalized tCBF measurement.

描述（由申请人提供）：这种生物工程 - 放射学 - 神经外科伙伴关系旨在进一步开发和测试一种新方法，用于非侵入性测量颅内依从性（ICC）和颅内压（ICP）（ICP）。这些重要的神经生理参数是使用血液和脑脊液（CSF）的动态磁共振成像（MRI）进行测量的。使用幻影，计算机模拟，非人类灵长类动物模型，健康志愿者和少量患者证明了这种新技术的可行性。这些参数的无创量化对于改善几种神经系统问题的诊断和治疗可能很重要。在该提案中，我们旨在证明非侵入性ICC测量的潜在临床实用性，以研究一个相对常见且知识熟悉的神经系统问题，Chiari畸形（CM）（与小脑扁桃体向下移位有关脊柱管中）。一些证据表明，ICC在该疾病的病理生理学中起重要作用。但是，由于这些患者中与侵入性ICC测量相关的脑部催眠风险增加，因此颅内依从性先前尚未得到测量。 CM中无创的ICC测量可能有助于解释病理生理学，并有可能改善这种令人衰弱的疾病的诊断和治疗。此外，由于MRI已用于诊断CM，因此添加额外的扫描以无创的添加ICC测量是实际的。虽然颅内依从性量化了颅内室可容纳体积增加（例如脑肿胀）而不会大大增加压力的能力，但临床上更广泛使用的是ICP。我们基于MRI的ICP测量取决于ICC与ICP之间的反相关关系。我们提出了对9例MR-ICP和ICP的侵入率测量之间发现的强态线性相关性的进一步验证。提出的验证是该方法可以在临床上可以接受并可以在其他神经系统问题中评估非侵入性MR-ICP的潜在高诊断价值之前的重要步骤。该提案的发展组成部分旨在改善MRI数据采集方案并缩短整体扫描时间，主要是通过ICP的多次采样并允许ICP的动态测量来提高测量可靠性。拟议的发育工作还旨在通过使受试者的总脑组织体积和重量标准化MR-ICP测量的总脑血流（TCBF）（TCBF）的测量。初步结果表明，标准化TCBF测量的个体间变异性较小。