Highly-timed resolved myocardial blood-oxygen-level-dependent magnetic resonance imaging
The invention provides various methods for imaging a subject's cardiovascular system. The imaging methods may be used to diagnose or prognose various cardiovascular diseases in the subject, without contrast agents or radioactive tracers.
1. A method for imaging a cardiovascular system in a subject, comprising:
imaging at least a portion of the subject's cardiovascular system at rest so as to obtain at least one rest image and rest data of the at least a portion of the subject's cardiovascular system,
wherein imaging the at least a portion of the subject's cardiovascular system at rest comprises operating a magnetic resonance imaging (MRI) scanner and performing blood-contrast-based magnetic resonance imaging;
administering at least one stress agent to the subject to induce in the subject a vasodilatory response comprising a rising part corresponding to a rising period followed by a falling part corresponding to a decaying period, wherein the stress agent comprises at least one vasodilator;
imaging the at least a portion of the subject's cardiovascular system at stress at least from beginning of the administration of the at least one stress agent and including the rising period of the vasodilatory response, so as to obtain a series of stress images and stress data of the at least a portion of the subject's cardiovascular system corresponding to at least when the administration begins and the rising part of the vasodilatory response,
wherein imaging of the at least a portion of the subject's cardiovascular system at stress comprises operating the magnetic resonance imaging (MRI) scanner and performing the blood-contrast-based magnetic resonance imaging,
wherein the stress images and stress data are obtained at a time interval between each stress image, and
wherein the time interval between each stress image is a beat-to-beat heartbeat time interval, a multiple heartbeat time interval up to 45 seconds, or combinations thereof;
registering the series of stress images to the at least one rest image so as to obtain a series of motion-corrected images of the at least a portion of the subject's cardiovascular system corresponding to at least when the administration begins and the rising part of the vasodilatory response; and
curve fitting the series of the stress data corresponding to from when the administration begins to the rising part of the vasodilatory response as a function of time, and solving therefrom for a time constant of the rising part of the vasodilatory response as an index of vascular reactivity in the rising part of the vasodilatory response of the at least a portion of the subject's cardiovascular system;
wherein the blood-contrast-based magnetic resonance imaging comprises T2 or T2*-based sequences comprising a low rank tensor.
2. The method of claim 1 , wherein the portion of the subject's cardiovascular system is selected from the group consisting of a heart, a portion of a heart, at least one blood vessel, a portion of a blood vessel, and combinations thereof, and wherein the portion of the heart comprises a myocardium, the blood vessel comprises a vein, an artery, a capillary, or a combination thereof, and the artery comprises a coronary artery.
3. The method of claim 1 , wherein the blood-contrast-based magnetic resonance imaging is selected from the group consisting of perfusion sensitive magnetic resonance imaging, blood oxygenation sensitive magnetic resonance imaging, blood flow sensitive magnetic resonance imaging, blood volume sensitive magnetic resonance imaging, blood-oxygen-level dependent magnetic resonance imaging (BOLD MRI), and combinations thereof.
4. The method of claim 1 , wherein the blood-contrast-based magnetic resonance imaging is blood-oxygen-level dependent magnetic resonance imaging (BOLD MRI), wherein the BOLD MRI is characterized by one or more of:
free-breathing,
not ECG-gated, and
respiratory and cardiac phase-resolved.
5. The method of claim 4 , wherein the blood oxygen level dependent magnetic resonance imaging (BOLD-MRI) comprises a T2-based sequence, wherein the T2-based sequence comprises the low rank tensor.
6. The method of claim 1 , wherein the vasodilator is selected from the group consisting of regadenoson, binodenoson, apadenoson, dipyridamole, adenosine, and combinations thereof.
7. The method of claim 1 , wherein the vasodilator is administered at 0.01-10 mg.
8. The method of claim 1 , wherein the vasodilator is administered at 0.1-100 μg/kg body weight.
9. The method of claim 1 , wherein the vasodilator is administered intravascularly, intravenously, intraarterially, or intracoronary.
10. The method of claim 1 , wherein the vasodilator is administered as a single bolus, wherein the single bolus comprises 0.01-10 mg of the vasodilator.
11. The method of claim 1 , wherein the vasodilator comprises CO 2 and the vasodilator is administered by inhalation in a stepwise or block-wise manner to reach a predetermined PaCO 2 in the subject.
12. The method of claim 1 , wherein the multiple heartbeat time interval is up to 2 seconds.
13. The method of claim 1 , wherein no radioactive tracer or contrast agent is administered to the subject.
14. The method of claim 1 , wherein the cardiovascular disease is selected from infarcted myocardium, coronary artery disease, coronary heart disease, ischemic heart disease, cardiomyopathy, stroke, hypertensive heart disease, heart failure, pulmonary heart disease, ischemic syndrome, coronary microvascular disease, cardiac dysrhythmias, rheumatic heart disease, aortic aneurysms, cardiomyopathy, atrial fibrillation, congenital heart disease, endocarditis, inflammatory heart disease, endocarditis, inflammatory cardiomegaly, myocarditis, valvular heart disease, cerebrovascular disease, and peripheral artery disease.
15. The method of claim 1 , further comprising: measuring a difference or an absence thereof in the index of vascular reactivity in the rising part of the vasodilatory response of the at least a portion of the subject's cardiovascular system, compared to that in a reference, wherein the reference is a control subject that does not have the cardiovascular disease, or another subject that has been treated for the cardiovascular disease.
16. The method of claim 1 , further comprising: measuring a difference or an absence thereof in the index of vascular reactivity in the rising part of the vasodilatory response of the at least a portion of the subject's cardiovascular system, compared to that in a reference, wherein the reference is a remote territory of the subject not affected by a cardiovascular disease.
17. The method of claim 16 , further comprising administering a treatment for cardiovascular disease to the subject measured with a difference in the index of vascular reactivity in the rising part of the vasodilatory response compared to the reference, wherein the treatment comprises coronary revascularization through stenting, coronary bypass grafting, statins, aspirin, or a combination thereof.
18. The method of claim 1 , further comprising imaging the at least a portion of the subject's cardiovascular system at stress during the decaying period corresponding to the falling part of the vasodilatory response.
19. The method of claim 1 , wherein the multiple heartbeat time interval is up to 10 seconds.
20. The method of claim 1 , wherein the multiple heartbeat time interval is up to 15 seconds.