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

基本信息

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
项目类别：
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

项目摘要

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.

项目摘要大血管狭窄或闭塞是脑血管疾病（CVD）的主要原因之一所有社会的死亡和残疾给全世界带来了巨大的社会经济负担。定量脑灌注图越来越多地应用于临床检查的不同阶段，包括评估受影响血管区域的微循环急剧变化，指导药物治疗与介入治疗，预测和纵向随访。含有[15O]-水的PET被认为是以下物质的参考标准：脑血流量 (CBF) 测量，但在血管临床评估方面不如 CT 和 MRI 更容易实现疾病。临床磁共振灌注图的支柱是动态磁敏感造影剂灌注加权成像（DSC-PWI）。对于患有大血管闭塞性疾病的患者，准确的 CBF 定量需要对长动脉转运延迟不敏感的反卷积技术。动脉自旋标记（ASL）的能力在不依赖外源性造影剂的情况下估计绝对 CBF 提供了一种非侵入性、更在非急性情况下，特别是当存在以下情况时，通常是 DSC-PWI 的定量替代方案：钆造影的禁忌症。 ASL 方法通常应用空间选择性标记模块供应远离成像体积的动脉。推荐用于临床的标准化 ASL 技术应用是单延迟伪连续 ASL (PCASL) 方法，已知该方法对延误运输时间。新开发的速度选择性动脉自旋标记（VSASL）可以最大限度地减少时间延迟灵敏度高，但由于使用基于饱和的标记模块，信噪比较低。我们最近开发的基于傅里叶变换的速度选择反演（FT-VSI）脉冲序列，允许对灌注信号具有更高的敏感性，并且对梯度缺陷具有更好的免疫力。本研究的目的是首先在健康人群中进一步完善 VSASL 技术（目标 1）；然后评估再现性和健康人 VSASL 的敏感性（目标 2）；最后评估和验证 VSASL 在大面积患者中的应用血管狭窄闭塞 CVD（目标 3）。所提议的 VSASL 技术预计将显示出临床价值，而不是不仅适用于大脑，还适用于身体的其他部位，尤其有益于儿童、孕妇和患者患有糖尿病或肾功能受损。