2021 Fiscal Year Final Research Report
Cardiac allograft vasculopathy analyzed by intra-voxel incoherent motion diffusion MRI
| Project/Area Number |
19K08209
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Multi-year Fund |
|---|
| Section | 一般 |
|---|
| Review Section |
Basic Section 52040:Radiological sciences-related
|
|---|
| Research Institution | Tokyo Women's Medical University |
|---|
Principal Investigator |
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
布田 伸一 東京女子医科大学, 医学部, 教授 (20172744)
|
|---|
| Project Period (FY) |
2019-04-01 – 2022-03-31
|
| Keywords | 心臓移植 / MRI / 移植後冠動脈病変 / T1 mapping / 拡散強調 |
|---|
| Outline of Final Research Achievements |
Cardiac MRI was performed on 27 patients after heart transplantation. Cardiac MRI included cine imaging for cardiac function, T1, T2 mapping and IVIM diffusion-weighted for myocardial evaluation, and MR angiography for coronary artery lesions. Invasive myocardial biopsy was performed in all patients and analyzed for cardiac allograft vasculopathy and rejection. Patients with pathologically proven Quilty lesions associated with lymphocytic infiltration had significantly prolonged myocardial T1 values, which have been reported to be associated with the development of rejection and myocardial damage caused by post-transplant immunosuppressive agents, and T1 mapping was used to detect them. T1 mapping is expected to be a noninvasive, low patient burden means of detecting these lesions.
|
| Free Research Field |
放射線医学
|
| Academic Significance and Societal Importance of the Research Achievements |
心臓移植後患者には、一年毎のカテーテル検査による冠動脈造影と心筋生検を実施し、移植後冠動脈病変や拒絶反応を評価することが必要とされている。患者にとって大きな負担とリスクであった。心臓MRIでは、放射線被ばくや造影剤を使用せずに冠動脈病変と心筋性状を同時に評価できる。MRI心筋マッピング技術進歩は著しく、心筋の浮腫、炎症、線維化を定量化した多くの情報を得られる。それらを統合的に解析し、診断精度や予後を予測するradiomicsも進化している。生検による病理組織とT1, T2, IVIMを対比し関連性を明らかにすることは、心臓移植後患者の侵襲的検査の軽減や心筋生検の代替えとなることが期待される。
|
