Velocity-Selective Arterial Spin Labeling based Perfusion Mapping for Cerebrovascular Diseases

基于速度选择性动脉自旋标记的脑血管疾病灌注图

• 批准号: 10000991
• 负责人: Qin Qin
• 金额: $ 39.56万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10000991
• 关键词: 3-Dimensional; Acute; Affect; Arteries; Blood Preservation; Blood Vessels; Blood flow; Brain; Carbon Dioxide; Cause of Death; Cerebrovascular Circulation; Cerebrovascular Disorders; Cerebrovascular Occlusions; Cerebrum; Child; Chronic; Clinic; Clinical; Contrast Media; Development; Diabetes Mellitus; Diagnosis; Disease; Distant; Economic Burden; Ensure; Evaluation; Fourier Transform; Gadolinium; Gases; Hypercapnia; Image; Immunity; Impairment; Inhalation; Label; Magnetic Resonance Imaging; Medical; Methodology; Methods; Microcirculation; Modality; Modeling; Neurologic; Noise; Organ; Patients; Perfusion; Physiologic pulse; Play; Positron-Emission Tomography; Predisposition; Pregnant Women; Protocols documentation; Radiation exposure; Reference Standards; Renal function; Reproducibility; Research; Rest; Role; Scheme; Signal Transduction; Societies; Spin Labels; Standardization; Stenosis; Techniques; Therapeutic Intervention; Time; Tissues; Training; Vascular Diseases; Vendor; Water; base; blood flow measurement; cerebral blood volume; clinical application; design; disability; experimental study; healthy volunteer; hemodynamics; imaging modality; magnetic field; novel; outcome forecast; perfusion imaging; prognostic; research clinical testing; social; soft tissue

Project Abstract Cerebrovascular diseases (CVD) with large-vessel stenosis or occlusion as one of the leading causes of death and disability in all societies, impose enormous social-economic burden worldwide. Quantitative cerebral perfusion mapping is increasingly utilized at different stages of clinical workup, including evaluation of the microcirculation of affected vascular territories acutely and beyond, guiding medical vs. interventional therapy, prognostication, and longitudinal follow-ups. PET with [15O]-water is considered as the reference standard for cerebral blood flow (CBF) measurement but is less accessible than CT and MRI for clinical evaluation of vascular diseases. The mainstay of clinical MR perfusion mapping is dynamic susceptibility contrast perfusion weighted imaging (DSC-PWI). For patients with large vessel occlusive diseases, accurate CBF quantification requires a deconvolution technique that is insensitive to long arterial transit delay. The ability of arterial spin labeling (ASL) to estimate absolute CBF without relying on exogenous contrast agents provides a non-invasive, more quantitative, and often preferred alternative to DSC-PWI in the non-acute setting, particularly when there is contraindication to Gadolinium contrast. ASL methods typically apply spatially selective labeling modules at supplying arteries distant from imaging volumes. The standardized ASL technique recommended for clinical applications is the single-delay pseudo-continuous ASL (PCASL) method, which is known to be sensitive to delayed transit time. Newly developed velocity-selective arterial spin labeling (VSASL) can minimize the time- delay sensitivity but suffers low signal-to-noise ratio due to the use of saturation-based labeling modules. We recently developed Fourier transform based velocity-selective inversion (FT-VSI) pulse trains that allows higher sensitivity to perfusion signal and better immunity to gradient imperfection. The purpose of this study is first to further refine VSASL techniques in healthy people (Aim 1); then to assess the reproducibility and sensitivity of VSASL in healthy people (Aim 2); and finally to evaluate and validate VSASL in patients with large- vessel steno-occlusive CVD (Aim 3). The proposed VSASL techniques are expected to show clinical values not only for the brain, but also for the rest of the body, and especially benefit children, pregnant women, and patients with diabetes or impaired kidney function.

项目摘要 脑血管疾病（CVD），具有大老板狭窄或阻塞是主要原因之一 所有社会的死亡与残疾，在全球造成巨大的社会经济负担。定量大脑 灌注图越来越多地在临床工作的不同阶段使用，包括评估 受影响的血管领土的微循环急性及以后，指导医学与介入疗法， 预后和纵向随访。具有[15o]水的宠物被认为是 脑血流（CBF）测量值，但比CT易于访问和MRI，用于血管的临床评估 疾病。临床MR灌注映射的支柱是动态敏感性对比度灌注加权 成像（DSC-PWI）。对于患有大血管闭塞性疾病的患者，准确的CBF定量需要 对长动脉传输延迟不敏感的反卷积技术。动脉自旋标记（ASL）的能力 估计绝对CBF而不依赖外源性对比剂，可提供一种无创的，更多的 在非急性环境中，定量，通常是DSC-PWI的选择，尤其是在有 gadolin对比的禁忌症。 ASL方法通常在空间选择性标记模块上 提供远离成像量的动脉。建议用于临床的标准化ASL技术 应用程序是单层伪连续的ASL（PCASL）方法，已知对 延迟运输时间。新开发的速度选择性动脉自旋标记（VSASL）可以最大程度地减少时间 延迟灵敏度，但由于使用基于饱和的标记模块而遭受较低的信噪比。我们 最近开发的基于傅立叶变换的速度选择性反转（FT-VSI）脉冲列车允许 对灌注信号的敏感性更高，对梯度不完美的免疫力更好。这项研究的目的是 首先要进一步完善健康人的VSASL技术（AIM 1）；然后评估可重复性和 VSASL在健康人中的敏感性（AIM 2）；最后，在大型患者中评估和验证VSASL 血管Steno-Cocclusive CVD（AIM 3）。提出的VSASL技术预计将显示临床值而不是 仅适用于大脑，但也适用于身体的其余部分，尤其是对儿童，孕妇和患者的好处 糖尿病或肾功能受损。