Abstract

The goal of this proposal is to build upon the technical knowledge gaine from the first submission concerning MRA acquisition parameters and techniques and apply this to a large patient base at the Cleveland Clini to address specific clinical questions concerning cerebrovascular disease. Initial efforts will utilize newly acquired technical capability to realize the theoretical improvements predicted by the firs proposal. This will include an assessment of the relative effectiveness and compatibility of MRA techniques to improve vessel contrast and the impact of enhanced gradient performance on flow artifacts, spatial resolution or reduced examination time. The clinical portion of the proposal is directed towards the implementation of these refinements in well designed prospective clinical studies. We will test the hypothesis that optimized time-of-flight MRA is of sufficient accuracy to replace intra-arterial angiography prior to carotid endarterectomy. We will als test the effectiveness and evaluate the benefit of MRA as a screening tool for the detection of unruptured intracranial aneurysms in high risk patient populations. This clinical data will provide a rational basis to assess MRA's role in the routine diagnosis and management of cerebrovascular disease. In addition, these studies should permit the preliminary evaluation of MRA's economic impact and role in patient outcome by providing more accurate natural history data and consequent improved clinical decision making.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
2R01HL043812-04
Application #
2221188
Study Section
Diagnostic Radiology Study Section (RNM)
Project Start
1990-08-01
Project End
1997-11-30
Budget Start
1994-12-01
Budget End
1995-11-30
Support Year
4
Fiscal Year
1995
Total Cost
Indirect Cost

  Institution

Name
Cleveland Clinic Lerner
Department
Type
DUNS #
017730458
City
Cleveland
State
OH
Country
United States
Zip Code
44195

  Publications

Obuchowski, N A (2001) Can electronic medical images replace hard-copy film? Defining and testing the equivalence of diagnostic tests. Stat Med 20:2845-63
Obuchowski, N A; Lieber, M L; Magdenic, M et al. (1999) Small but quantifiable patient preference for MRA versus catheter angiography. Stroke 30:2247-8
Perl 2nd, J; Tkach, J A; Porras-Jimenez, M et al. (1999) Hemorrhage detected using MR imaging in the setting of acute stroke: an in vivo model. AJNR Am J Neuroradiol 20:1863-70
Obuchowski, N A (1997) Nonparametric analysis of clustered ROC curve data. Biometrics 53:567-78
Obuchowski, N A; Modic, M T; Magdinec, M et al. (1997) Assessment of the efficacy of noninvasive screening for patients with asymptomatic neck bruits. Stroke 28:1330-9
Ding, X; Tkach, J; Ruggieri, P et al. (1997) Improvement of spiral MRI with the measured k-space trajectory. J Magn Reson Imaging 7:938-40
Tkach, J A; Ding, X; Ruggieri, P M et al. (1997) Segmented three-dimensional echo-planar flow imaging of the cervical carotid arteries. AJNR Am J Neuroradiol 18:1339-47
Ruggieri, P M; Poulos, N; Masaryk, T J et al. (1994) Occult intracranial aneurysms in polycystic kidney disease: screening with MR angiography. Radiology 191:33-9
Ding, X; Tkach, J A; Ruggieri, P R et al. (1994) Sequential three-dimensional time-of-flight MR angiography of the carotid arteries: value of variable excitation and postprocessing in reducing venetian blind artifact. AJR Am J Roentgenol 163:683-8
Tkach, J A; Ruggieri, P M; Dillinger, J J et al. (1993) Three-dimensional time-of-flight MR angiography with a specialized gradient head coil. J Magn Reson Imaging 3:365-75

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