Rapid Real-Time MR Angiography of Suspected Stroke

疑似中风的快速实时 MR 血管造影

• 批准号: 9789874
• 负责人: Ioannis Koktzoglou
• 金额: $ 47.28万
• 依托单位: NORTHSHORE UNIVERSITY HEALTHSYSTEM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9789874
• 关键词: Acceleration; Affect; American; Anatomy; Angiography; Arteriogram; Blood Circulation; Blood Vessels; Blood flow; Brain; Carotid Endarterectomy; Characteristics; Chronic Kidney Failure; Circle of Willis; Coagulation Process; Consumption; Contrast Media; Cytolysis; Data; Detection; Development; Diagnostic; Diagnostic Imaging; Diffusion Magnetic Resonance Imaging; Evaluation; Goals; Head and neck structure; High Prevalence; Image; Image Analysis; Imaging Techniques; Impaired Renal Function; Interruption; Intracranial Hemorrhages; Intravenous; Ischemic Stroke; Kidney Diseases; Magnetic Resonance; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Measurement; Medical; Morphologic artifacts; Motion; Neck; Outcome; Patients; Pattern; Physiologic pulse; Pilot Projects; Protocols documentation; Radial; Reproducibility; Sampling; Scanning; Slice; Societies; Speed; Spin Labels; Stenosis; Stroke; System; Techniques; Technology; Testing; Time; anatomic imaging; aortic arch; base; bulk motion; contrast enhanced; cost; diffusion weighted; disability; experience; hemodynamics; high risk population; image reconstruction; imaging modality; improved; innovation; middle cerebral artery; neurovascular; next generation; perfusion imaging; real-time images; reconstruction; stroke patient; stroke-like outcome; success; temporal measurement

Project Summary/Abstract: The objective of this project is to develop and validate very rapid and robust next-generation magnetic resonance (MR) protocols for anatomic and hemodynamic evaluation of the head and neck vessels in patients with suspected stroke. Emergent diagnostic imaging evaluation of suspected stroke typically involves a non- contrast CT to detect intracranial hemorrhage. However, subsequent patient management is based on the much more extensive anatomical and functional information provided by magnetic resonance imaging (MRI). The MRI protocol typically consists of anatomic imaging, diffusion-weighted imaging, MR angiography (MRA) to detect stenosis and occlusion in the neurovascular system, and contrast-enhanced perfusion imaging. MRA is by far the most time-consuming of these imaging techniques (typically requiring 15 minutes or longer for the combined evaluation of the neck vessels and circle of Willis), and the most prone to degradation from patient motion. Given that “time is brain” in the emergent evaluation of stroke, the first goal of this project is to achieve a five-fold or greater decrease in scan time for neurovascular MRA to <3 minutes without the use of contrast agents, while improving reliability using motion-insensitive imaging techniques. Another goal of this project is to develop a rapid protocol for portraying and quantifying intracranial flow patterns and velocities in <30 seconds. We hypothesize that these two goals can be met through the development of two protocols: 1) a highly-accelerated ungated quiescent-interval slice-selective (UnQISS) protocol leveraging radial sampling, real-time motion detection, and simultaneous multi-slice acceleration; and 2) an efficient semi-projective cine arterial spin-labeled (ASL) protocol providing high temporal resolution. A final goal of this project is to test the developed rapid UnQISS and cine ASL protocols in a group of patients with suspected stroke. The expected outcome of this project is a set of rapid protocols for evaluating the neurovascular system in patients with suspected stroke that expeditiously informs the treatment team to guide management decisions regarding medical and endovascular therapy. Since no contrast agents are involved, the developed protocols will be especially useful in the many stroke patients (1 in 3) who present with chronic kidney disease. The specific aims of this project are as follows: 1. To develop and optimize a rapid nonenhanced MRI protocol that provides for anatomical assessment of the intracranial and extracranial vessels (aortic arch to circle of Willis) in <3 minutes. 2. To develop a rapid semi-projective arterial spin-labeling cine technique for displaying and quantifying intracranial flow in <30 sec. 3. In suspected stroke patients, to test the hypotheses that the developed rapid protocols, with respect to currently-used MR protocols, improve image quality, provide more diagnostic information, accurately portray intracranial flow patterns, and decrease scan times.

项目摘要/摘要： 该项目的目的是开发和验证非常快速，强大的下一代磁 共振（MR）方案用于对患者头部和颈部血管的解剖和血液动力学评估 怀疑中风。可疑中风的紧急诊断成像评估通常涉及非 - 对比CT检测颅内出血。但是，随后的患者管理是基于 磁共振成像（MRI）提供的更广泛的解剖和功能信息。 MRI方案通常包括解剖成像，扩散加权成像，MR血管造影（MRA） 检测神经血管系统中的狭窄和闭塞，以及对比增强的灌注成像。 MRA 到目前为止，这些成像技术最耗时（通常需要15分钟或更长时间 颈部容器和威利斯圆圈的联合评估），最容易从患者那里退化 运动。鉴于“时间是大脑”在对中风的紧急评估中，该项目的第一个目标是实现 在不使用对比度的情况下，神经血管MRA的扫描时间减少了五倍或更高 代理，同时使用对运动不敏感的成像技术提高可靠性。这个项目的另一个目标是 开发一个快速的方案，用于描绘和量化颅内流动模式和速度<30 秒。我们假设可以通过制定两个协议来实现这两个目标：1）a 高加速的未调节的静脉间隔切片选择性（UNQISS）方案利用径向采样， 实时运动检测和同时进行多片加速度； 2）有效的半标准类 动脉自旋标记（ASL）方案提供高临时分辨率。该项目的最终目标是测试 一组可疑中风的患者，开发了迅速的不QISS和CINE ASL方案。预期 该项目的结果是一组快速方案，用于评估患者的神经血管系统 怀疑的中风迅速告知治疗团队，指导管理决策 医学和血管内治疗。由于不涉及对比剂，因此开发的协议将是 在出现慢性肾脏疾病的许多中风患者（三分之一）中特别有用。具体 该项目的目的如下：1。开发和优化一种快速的非增强MRI协议 提供对颅内和颅外血管（主动脉拱到Willis圈）的解剖学评估 <3分钟。 2。开发一种快速的半标志性动脉自旋标记的电影技术，用于显示和 在<30秒内量化颅内流动。 3。在怀疑的中风患者中，以检验假设 开发了有关当前使用的MR协议的快速协议，提高图像质量，提供更多 诊断信息，准确描绘颅内流动模式，并减少扫描时间。