A new paradigm of cardiovascular MRI for pediatric congenital heart disease

小儿先天性心脏病心血管 MRI 的新范例

• 批准号: 8985563
• 负责人: Peng Hu
• 金额: $ 67.21万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-15 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8985563
• 关键词: Acceleration; Address; Adult; Affect; Anatomy; Angiography; Apnea; Birth; Blood Vessels; Blood flow; Bolus Infusion; Breathing; Cardiac; Cardiac Catheterization Procedures; Cardiovascular system; Catheterization; Child; Childhood; Cine Magnetic Resonance Imaging; Clinical; Communities; Complement; Complex; Congenital Abnormality; Contrast Media; Coronary artery; Data; Development; Diagnosis; Diagnostic; Dose; Echocardiography; Environmental air flow; Evaluable Disease; Evaluation; Exposure to; Financial compensation; Gadolinium; General Anesthesia; Geometry; Goals; Heart; Hybrids; Image; Institution; Intubation; Ionizing radiation; Knowledge; Label; Live Birth; Magnetic Resonance Imaging; Methods; Motion; Patients; Phase; Physicians; Physiologic pulse; Play; Protocols documentation; Radial; Reference Standards; Resolution; Role; Sampling; Scanning; Scheme; Signal Transduction; Slice; Structure; Techniques; Testing; Thick; Time; To specify; Validation; Ventilator; base; cohort; congenital heart disorder; contrast enhanced; experience; falls; ferumoxytol; follow-up; gadolinium oxide; heart imaging; imaging modality; iron deficiency; iron oxide; nanoparticle; neonate; nephrotoxicity; patient safety; pressure; prevent; public health relevance; radiologist; reconstruction; respiratory; treatment planning

 DESCRIPTION (provided by applicant): Congenital heart disease (CHD) is the most common congenital defect affecting approximately 1% of live births. Initially developed and optimized for adults, cardiovascular MRI (CMR) is increasingly used in pediatric CHD patients to complement echocardiography and invasive angiography for anatomical and functional evaluation of the heart and blood vessels. For children, the non-invasiveness, unrestricted field of view, lack of contrast nephrotoxicity and absence of ionizing radiation make MRI an attractive imaging modality, as many of the patients will likely need sequential imaging and follow-up in the long term. However, current CMR is limited by the breath-holding period, the need to capture the first-pass of a gadolinium (Gd) bolus and relatively thick 2D slices in cardiac cine MRI. Consequently, despite yielding exquisitely detailed information on extra-cardiac vascular anatomy, current CMR methods fall short of providing comparable definition of dynamic intra-cardiac anatomy, such as the cardiac chambers, valves, coronary arteries, and other pulsatile blood vessels, despite the fact that the status of these structures often determines the basis for treatment planning. We propose a new paradigm of CMR in pediatric CHD to address these issues. Completion of the project will result in the clinical deployment of a set of MRI pulse sequences, image acquisition and reconstruction strategies CMR in pediatric CHD patients, and successful validation in a cohort of patients of its diagnostic value.

 描述（由申请人提供）：先天性心脏病 (CHD) 是最常见的先天性缺陷，影响约 1% 的活产儿。心血管 MRI (CMR) 最初是针对成人开发和优化的，现在越来越多地用于儿科 CHD 患者，以补充超声心动图和检查。用于心脏和血管的解剖和功能评估的侵入性血管造影对于儿童而言，具有非侵入性、不受视野限制、缺乏造影剂肾毒性和无造影剂。电离辐射使 MRI 成为一种有吸引力的成像方式，因为从长远来看，许多患者可能需要连续成像和随访。然而，目前的 CMR 受到屏气期的限制，需要捕获第一遍影像。在心脏电影 MRI 中检查了钆 (Gd) 丸剂和相对较厚的 2D 切片，尽管可以提供有关心脏外血管解剖结构的详细信息，但当前的 CMR 方法仍无法提供动态心脏内解剖结构的可比定义，例如心腔、瓣膜、冠状动脉和其他搏动血管，尽管这些结构的状态通常决定了治疗计划的基础，但我们提出了一种新的儿科 CMR 范例来解决这些问题。该项目的结果将是在儿童先心病患者中临床部署一套 MRI 脉冲序列、图像采集和重建策略 CMR，并在一组患者中成功验证其诊断价值。