1
|
Piras P, Torromeo C, Evangelista A, Gabriele S, Esposito G, Nardinocchi P, Teresi L, Madeo A, Schiariti M, Varano V, Puddu PE. Homeostatic Left Heart integration and disintegration links atrio-ventricular covariation's dyshomeostasis in Hypertrophic Cardiomyopathy. Sci Rep 2017; 7:6257. [PMID: 28740203 PMCID: PMC5524707 DOI: 10.1038/s41598-017-06189-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/07/2017] [Indexed: 12/29/2022] Open
Abstract
Left ventricle and left atrium are and have been practically always analyzed separately in common clinically and non-clinically oriented cardiovascular investigations. Both classic and speckle tracking echocardiographic data contributed to the knowledge about deformational impairments occurring in systo-diastolic differences. Recently new trajectory based approaches allowed a greater awareness about the entire left ventricle or left atrium revolution and on their deficiencies that take place in presence of hypertrophic cardiomyopathy. However, surprisingly, the concomitant function of the two left heart chambers has not been analyzed for their geometrical/mechanical relationship. For the first time we study here, by acquiring left ventricle and left atrial geometries on the same heartbeat, the trajectory attributes of the entire left heart treated as a whole shape and the shape covariation of its two subunits. We contrasted healthy subjects with patients affected by hypertrophic cardiomyopathy. We found impaired left heart trajectory mainly in terms of orientation and size. More importantly, we found profound differences in the direction of morphological covariation of left ventricle and left atrium. These findings open to new perspectives in pathophysiological evaluation of different diseases by allowing the appreciation of concomitant functioning of both left heart whole geometry and of its two chambers.
Collapse
Affiliation(s)
- Paolo Piras
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza - Università di Roma, Rome, Italy.,Dipartimento di Ingegneria Strutturale e Geotecnica, Sapienza - Università di Roma, Rome, Italy
| | - Concetta Torromeo
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza - Università di Roma, Rome, Italy
| | | | - Stefano Gabriele
- Dipartimento di Architettura, LaMS - Modeling & Simulation Lab, Università Roma Tre, Rome, Italy
| | - Giuseppe Esposito
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza - Università di Roma, Rome, Italy
| | - Paola Nardinocchi
- Dipartimento di Ingegneria Strutturale e Geotecnica, Sapienza - Università di Roma, Rome, Italy
| | - Luciano Teresi
- Dipartimento di Matematica e Fisica, LaMS - Modeling & Simulation Lab, Università Roma Tre, Rome, Italy
| | - Andrea Madeo
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza - Università di Roma, Rome, Italy
| | - Michele Schiariti
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza - Università di Roma, Rome, Italy
| | - Valerio Varano
- Dipartimento di Architettura, LaMS - Modeling & Simulation Lab, Università Roma Tre, Rome, Italy
| | - Paolo Emilio Puddu
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza - Università di Roma, Rome, Italy.
| |
Collapse
|
2
|
Busato A, Balconi G, Vismara V, Bertelè L, Garo G, DE Gregorio D. Management and control of isotonic contraction generated stress: evaluation of masseter muscle deformation pattern by means of ecography. ACTA ACUST UNITED AC 2017; 9:45-53. [PMID: 28280532 DOI: 10.11138/orl/2016.9.1s.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The objective of the following study is to observe the behavior of the six layers of the masseter during an isometric contraction at maximum exertion with the deformation pattern analysis method. MATERIALS AND METHODS This study has been conducted by use of an ultrasound machine (MicrUs ext-1H Telemed Medical Systems Milano) and a linear probe (L12-5l40S-3 5-12 MHz 40 mm) which allowed us to record a video (DCM) comprised of 45 frames per second. The probe was fixed to a brace and the patient was asked to clench their teeth as hard as possible, obtain the muscle's maximum exertion, for 5 seconds three times, with 30 seconds intervals in between. Both right and left masseter muscles were analyzed. Then we applied to the resulting video a software (Mudy 1.7.7.2 AMID Sulmona Italy) for the analysis of muscle deformation patterns (contraction, dilatation, cross-plane, vertical strain, horizontal strain, vertical shear, horizontal shear, horizontal displacement, vertical displacement). The number of videos of masseter muscles in contraction at maximum exertion due to dental clenching made during this research is around 12,000. Out of these we chose 1,200 videos which examine 200 patients (100 females, 100 males). RESULTS The analysis of the deformation patterns of the masseter allows us to observe how the six layers of the muscle have different and specific functions each, which vary depending on the applied force (application point, magnitude and direction) so that we find it impossible to assign to one of the three sections of the muscle a mechanical predominance. Therefore it appears that the three parts of the muscle have specific and synergistic tasks.
Collapse
Affiliation(s)
| | - G Balconi
- Department of Radiology, Hospital San Raffaele Turro, Milano, Italy
| | | | | | - G Garo
- President and Founder of Siach - The International Society of Surgical Anatomy
| | - D DE Gregorio
- Director of Siach, Aesthetic Surgeon, Perugia, Italy
| |
Collapse
|
3
|
Busato A, Balconi G, Vismara V, Bertelè L, Garo G, DE Gregorio D. Ultrasound and analysis of the deformation patterns of the masseter muscle: comparing surgical anatomy, ultrasound and functional anatomy. ORAL & IMPLANTOLOGY 2017; 9:28-37. [PMID: 28280530 DOI: 10.11138/orl/2016.9.1s.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We have tried to demonstrate whether the analysis of the muscle strain allows us to identify the three distinct functional areas of the architecture of the masseter, as one would see them by performing or viewing an anatomical dissection of said muscle, and whether these sections have behave differently in terms of origin and coping of the strain they face (quantitative analysis). MATERIALS AND METHODS This work has been elaborated by the use of an ultrasound machine (MicrUs ext-1H Telemed Medical Systems Milano) and a linear probe (L12-5l40S-3 5-12 MHz 40 mm) which allowed us to record a 45 frame per second video (DCM). Videos has been elaborated by use of an ultrasound machine (MicrUs ext-1H Telemed Medical Systems Milano) and a linear probe (L12-5l40S-3 5-12 MHz 40 mm) which allowed us to record a 45 frame per second video (DCM). We applied to the resulting video a software (Mudy 1.7.7.2 AMID Sulmona Italy) for the analysis of muscle deformation patters (contraction, dilatation, cross-plane, vertical strain, horizontal strain, vertical shear, horizontal shear, horizontal displacement, vertical displacement). The number of videos of masseter muscles in contraction at maximum exertion due to dental clenching made during this research is around 12,000. Out of these we chose 1,200 videos which examine 200 patients (100 females, 100 males). RESULTS The deformation pattern analysis of the skeletal muscle on ultrasound basis seems to be an adequate instrument to use during the investigation of the functional structure of the masseter muscle given its ability to highlight the distinct activity of each separate part of the muscle. CONCLUSIONS Moreover the strain does not apply to the muscle uniformly; instead it varies according to the observed area.
Collapse
Affiliation(s)
| | - G Balconi
- Department of Radiology, Hospital San Raffaele Turro, Milano, Italy
| | | | | | - G Garo
- President and Founder of Siach - The International Society of Surgical Anatomy
| | - D DE Gregorio
- Director of Siach, Aesthetic Surgeon, Perugia, Italy
| |
Collapse
|
4
|
Clinical Application of 2D Speckle Tracking Strain for Assessing Cardio-Toxicity in Oncology. J Funct Morphol Kinesiol 2016. [DOI: 10.3390/jfmk1040343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
|
5
|
Pedrizzetti G, Claus P, Kilner PJ, Nagel E. Principles of cardiovascular magnetic resonance feature tracking and echocardiographic speckle tracking for informed clinical use. J Cardiovasc Magn Reson 2016; 18:51. [PMID: 27561421 PMCID: PMC5000424 DOI: 10.1186/s12968-016-0269-7] [Citation(s) in RCA: 261] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/27/2016] [Indexed: 01/29/2023] Open
Abstract
Tissue tracking technology of routinely acquired cardiovascular magnetic resonance (CMR) cine acquisitions has increased the apparent ease and availability of non-invasive assessments of myocardial deformation in clinical research and practice. Its widespread availability thanks to the fact that this technology can in principle be applied on images that are part of every CMR or echocardiographic protocol. However, the two modalities are based on very different methods of image acquisition and reconstruction, each with their respective strengths and limitations. The image tracking methods applied are not necessarily directly comparable between the modalities, or with those based on dedicated CMR acquisitions for strain measurement such as tagging or displacement encoding. Here we describe the principles underlying the image tracking methods for CMR and echocardiography, and the translation of the resulting tracking estimates into parameters suited to describe myocardial mechanics. Technical limitations are presented with the objective of suggesting potential solutions that may allow informed and appropriate use in clinical applications.
Collapse
Affiliation(s)
- Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Piet Claus
- Department of Cardiovascular Diseases, Laboratory for Cardiovascular Imaging and Dynamics, KU Leuven, Leuven, Belgium
| | - Philip J Kilner
- CMR Unit, Royal Brompton Hospital and Imperial College, London, UK
| | - Eike Nagel
- Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, Interdisciplinary Cardiovascular Imaging, Internal Medicine III and Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Main, Germany.
| |
Collapse
|
6
|
Pan X, Liu K, Shao J, Gao J, Huang L, Bai J, Luo J. Performance comparison of rigid and affine models for motion estimation using ultrasound radio-frequency signals. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2015; 62:1928-1943. [PMID: 26559623 DOI: 10.1109/tuffc.2015.007245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tissue motion estimation is widely used in many ultrasound techniques. Rigid-model-based and nonrigid-modelbased methods are two main groups of space-domain methods of tissue motion estimation. The affine model is one of the commonly used nonrigid models. The performances of the rigid model and affine model have not been compared on ultrasound RF signals, which have been demonstrated to obtain higher accuracy, precision, and resolution in motion estimation compared with B-mode images. In this study, three methods, i.e., the normalized cross-correlation method with rigid model (NCC), the optical flow method with rigid model (OFRM), and the optical flow method with affine model (OFAM), are compared using ultrasound RF signals, rather than the B-mode images used in previous studies. Simulations, phantom, and in vivo experiments are conducted to make the comparison. In the simulations, the root-mean-square errors (RMSEs) of axial and lateral displacements and strains are used to assess the accuracy of motion estimation, and the elastographic signal-tonoise ratio (SNRe) and contrast-to-noise ratio (CNRe) are used to evaluate the quality of axial strain images. In the phantom experiments, the registration error between the pre- and postdeformation RF signals, as well as the SNRe and CNRe of axial strain images, are utilized as the evaluation criteria. In the in vivo experiments, the registration error is used to evaluate the estimation performance. The results show that the affinemodel- based method (i.e., OFAM) obtains the lowest RMSE or registration error and the highest SNRe and CNRe among all the methods. The affine model is demonstrated to be superior to the rigid model in motion estimation based on RF signals.
Collapse
|
7
|
Lee JH, Hwang YN, Park SY, Jeong JS, Kim SM. An analysis of contrast agent flow patterns from sequential ultrasound images using a motion estimation algorithm based on optical flow patterns. IEEE Trans Biomed Eng 2014; 62:49-59. [PMID: 25020012 DOI: 10.1109/tbme.2014.2336672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study estimates flow patterns of contrast agents from successive ultrasound image sequences by using an anisotropic diffusion-based optical flow algorithm. Before flow fields were recovered, the test sequences were reconstructed using relative composition of structural and textural parts from the original image. To improve estimation performance, an anisotropic diffusion filtering model was embedded into a spline-based slightly nonconvex total variation-L1 minimization algorithm. In addition, an incremental coarse-to-fine warping framework was employed with a linear minimization scheme to account for a large displacement. After each warping iteration, the implementation used intermediate bilateral filtering to prevent oversmoothing across motion boundaries. The performance of the proposed algorithm was tested using three different sequences obtained from two simulated datasets and phantom ultrasound sequences. The results indicate the robust performance of the proposed method under different noise environments. The results of the phantom study also demonstrate reliable performance according to different injection conditions of contrast agents. These experimental results suggest the potential clinical applicability of the proposed algorithm to ultrasonographic diagnosis based on contrast agents.
Collapse
|
8
|
Fumagalli S, Gabbai D, Francini S, Rinaldi MC, Pedri S, Baldasseroni S, Tarantini F, Serio CD, Lonetto G, Bari MD, Padeletti L, Crijns HJ, Marchionni N. External Cardioversion of Atrial Fibrillation Causes an Early Improvement of Cardiac Performance: A Longitudinal Strain Analysis Study. J Cardiovasc Echogr 2014; 24:10-17. [PMID: 28465898 PMCID: PMC5353402 DOI: 10.4103/2211-4122.131987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction: Atrial fibrillation (AF) is often associated with heart failure. Several studies have demonstrated that resumption of sinus rhythm (SR) improves cardiac output in the long-term. Aims of this study were to evaluate the acute variations of left ventricular (LV) performance, following successful external cardioversion (ECV) of persistent AF using longitudinal strain (LSt) analysis, and the influence of inflammation. Materials and Methods: We enrolled 48 patients with AF (age: 73 ± 12 years, men: 83.3%). A standard transthoracic echocardiographic evaluation was performed before the procedure and 6 h later; this included the analysis of LV endocardial peak LSt, a measure of myocardial deformation. In the last 32 patients, plasma concentration of interleukin-6 (IL-6) was also determined. Results: Restoration of SR led to the decrease of heart rate (HR) (74 ± 21 vs 64 ± 10 bpm, P < 0.001) and LV end-systolic volume (30 ± 16 vs 27 ± 17 mL/m2, P = 0.001), and to the increase of LV end-diastolic volume (LVEDV) (56 ± 20 vs 60 ± 21 mL/m2, P = 0.036) and ejection fraction (EF) (48 ± 10 vs 57 ± 11%, P < 0.001). Peak LSt improved in 43 (89.6%) patients (-12.9 ± 3.3 vs -18.0 ± 4.7%, P < 0.001). Multivariate analysis (R = 0.729, P < 0.001) showed that strain changes were directly correlated with basal HR and the appearance of atrial mechanical activity and inversely correlated with corrected thyroid dysfunction, LVEDV and the presence of a permanent pacemaker. Higher levels of IL-6 negatively affected LV performance improvement. Conclusions: Effective ECV of AF determines a significant and fast improvement of LV performance, which is readily captured by LSt analysis. Inflammatory status may impact the response to SR restoration.
Collapse
Affiliation(s)
- Stefano Fumagalli
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Debbie Gabbai
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Sara Francini
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Marta Casalone Rinaldi
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | | | - Samuele Baldasseroni
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Francesca Tarantini
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Claudia Di Serio
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Giuseppe Lonetto
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Mauro Di Bari
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| | - Luigi Padeletti
- Department of Experimental and Clinical Medicine, Electrophysiology Unit and School of Cardiology, University of Florence and AOU Careggi, Florence, Italy
| | - Harry J Crijns
- Department of Cardiology and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, The Netherlands
| | - Niccolò Marchionni
- Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
| |
Collapse
|
9
|
Lee JH, Kim SM. Estimating contrast agent motion from ultrasound images using an anisotropic diffusion-based optical flow technique. Comput Biol Med 2013; 43:1853-62. [DOI: 10.1016/j.compbiomed.2013.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 09/02/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
|
10
|
Khabbaz KR, Mahmood F, Shakil O, Warraich HJ, Gorman JH, Gorman RC, Matyal R, Panzica P, Hess PE. Dynamic 3-dimensional echocardiographic assessment of mitral annular geometry in patients with functional mitral regurgitation. Ann Thorac Surg 2012; 95:105-10. [PMID: 23103005 DOI: 10.1016/j.athoracsur.2012.08.078] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mitral valve (MV) annular dynamics have been well described in animal models of functional mitral regurgitation (FMR). Despite this, little if any data exist regarding the dynamic MV annular geometry in humans with FMR. In the current study we hypothesized that 3-dimensional (3D) echocardiography, in conjunction with commercially available software, could be used to quantify the dynamic changes in MV annular geometry associated with FMR. METHODS Intraoperative 3D transesophageal echocardiographic data obtained from 34 patients with FMR and 15 controls undergoing cardiac operations were dynamically analyzed for differences in mitral annular geometry with TomTec 4D MV Assessment 2.0 software (TomTec Imaging Systems GmbH, Munich, Germany). RESULTS In patients with FMR, the mean mitral annular area (14.6 cm(2) versus 9.6 cm(2)), circumference (14.1 cm versus 11.4 cm), anteroposterior (4.0 cm versus 3.0 cm) and anterolateral-posteromedial (4.3 cm versus 3.6 cm) diameters, tenting volume (6.2 mm(3) versus 3.5 mm(3)) and nonplanarity angle (NPA) (154 degrees ± 15 versus 136 degrees ± 11) were greater at all points during systole compared with controls (p < 0.01). Vertical mitral annular displacement (5.8 mm versus 8.3 mm) was reduced in FMR compared with controls (p < 0.01). CONCLUSIONS There are significant differences in dynamic mitral annular geometry between patients with FMR and those without. We were able to analyze these changes in a clinically feasible fashion. Ready availability of this information has the potential to aid comprehensive quantification of mitral annular function and possibly assist in both clinical decision making and annuloplasty ring selection.
Collapse
Affiliation(s)
- Kamal R Khabbaz
- Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Leung KYE, Danilouchkine MG, van Stralen M, de Jong N, van der Steen AFW, Bosch JG. Left ventricular border tracking using cardiac motion models and optical flow. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:605-616. [PMID: 21376448 DOI: 10.1016/j.ultrasmedbio.2011.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 01/14/2011] [Accepted: 01/14/2011] [Indexed: 05/30/2023]
Abstract
The use of automated methods is becoming increasingly important for assessing cardiac function quantitatively and objectively. In this study, we propose a method for tracking three-dimensional (3-D) left ventricular contours. The method consists of a local optical flow tracker and a global tracker, which uses a statistical model of cardiac motion in an optical-flow formulation. We propose a combination of local and global trackers using gradient-based weights. The algorithm was tested on 35 echocardiographic sequences, with good results (surface error: 1.35 ± 0.46 mm, absolute volume error: 5.4 ± 4.8 mL). This demonstrates the method's potential in automated tracking in clinical quality echocardiograms, facilitating the quantitative and objective assessment of cardiac function.
Collapse
Affiliation(s)
- K Y Esther Leung
- Biomedical Engineering, Thoraxcenter, Erasmus MC, The Netherlands.
| | | | | | | | | | | |
Collapse
|
12
|
Hor KN, Baumann R, Pedrizzetti G, Tonti G, Gottliebson WM, Taylor M, Benson DW, Mazur W. Magnetic resonance derived myocardial strain assessment using feature tracking. J Vis Exp 2011:2356. [PMID: 21372778 PMCID: PMC3074463 DOI: 10.3791/2356] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that strain is a more sensitive and earlier marker for contractile dysfunction than the frequently used parameter EF. Current technologies for CMR are time consuming and difficult to implement in clinical practice. Feature tracking is a technology that can lead to more automization and robustness of quantitative analysis of medical images with less time consumption than comparable methods. Methods: An automatic or manual input in a single phase serves as an initialization from which the system starts to track the displacement of individual patterns representing anatomical structures over time. The specialty of this method is that the images do not need to be manipulated in any way beforehand like e.g. tagging of CMR images. Results: The method is very well suited for tracking muscular tissue and with this allowing quantitative elaboration of myocardium and also blood flow. Conclusions: This new method offers a robust and time saving procedure to quantify myocardial tissue and blood with displacement, velocity and deformation parameters on regular sequences of CMR imaging. It therefore can be implemented in clinical practice.
Collapse
Affiliation(s)
- Kan N Hor
- The Heart Institute, Cincinnati Children Hospital Medical Center (CCHMC), USA.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Little SH, Ben Zekry S, Lawrie GM, Zoghbi WA. Dynamic Annular Geometry and Function in Patients with Mitral Regurgitation: Insight From Three-Dimensional Annular Tracking. J Am Soc Echocardiogr 2010; 23:872-9. [DOI: 10.1016/j.echo.2010.06.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Indexed: 11/16/2022]
|
14
|
Di Bella G, Gaeta M, Pingitore A, Oreto G, Zito C, Minutoli F, Anfuso C, Dattilo G, Lamari A, Coglitore S, Carerj S. Myocardial deformation in acute myocarditis with normal left ventricular wall motion--a cardiac magnetic resonance and 2-dimensional strain echocardiographic study. Circ J 2010; 74:1205-13. [PMID: 20453384 DOI: 10.1253/circj.cj-10-0017] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of our study was to assess longitudinal (L), circumferential (C) and radial (R) strain (S) of the left ventricle (LV) in patients with acute myocarditis and preserved LV wall motion. METHODS AND RESULTS Of the 26 male patients that were enrolled, 13 patients (26+/-8 years) suffered from acute myocarditis and 13 (25+/-2 years) were healthy participants (controls). Both patients and controls underwent cardiac magnetic resonance (CMR) and 2-dimensional S imaging (2D-S) echocardiography on the same day. Myocardial strains (RS, LS and CS) were quantified by 2D-S. In patients with myocarditis, a delayed enhancement (DE) CMR study was performed to identify damaged myocardial segments. In the myocarditis group there was a significant LS reduction compared with controls (-25+/-7 vs -20+/-7, P<0.0001), whereas no difference was found between the 2 groups concerning CS and RS. Subepicardial DE areas were found in 12 of 13 patients. Segments with DE showed a significantly lower LS in comparison with segments without DE (-19+/-4 vs -23+/-6, P<0.0001). In contrast, no difference in CS and RS was found when comparing segments with DE vs segments without DE. CONCLUSIONS In patients with acute myocarditis, evidence of subepicardial damage and no wall motion abnormalities, longitudinal deformation is diffusely impaired, whereas circumferential impairment is regionally sited in the areas of subepicardial damage.
Collapse
Affiliation(s)
- Gianluca Di Bella
- Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Messina, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Sun FR, Zhang MQ, Jia XB, Wang XJ, Yao GH, Zhang Y. Numerical methods and workstation for the quantitative analysis of real-time myocardial contrast echocardiography. IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE : A PUBLICATION OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY 2010; 14:1204-10. [PMID: 20129869 DOI: 10.1109/titb.2010.2040395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using the quantitative analysis of real-time myocardial contrast echocardiography (RT MCE), clinicians can assess the myocardial perfusion of patients, noninvasively and accurately. We designed a workstation to assist clinicians to automatically implement the accurate analysis of RT MCE. The workstation can compute some hemodynamic parameters of myocardial microcirculation, e.g., myocardial blood flow, myocardial blood flow mean velocity, and myocardial blood volume. Our new methods involved in the quantitative analysis of RT MCE are summarized as follows. 1) A novel orthogonal array optimization (OAO) technique was proposed and used to estimate the unknown parameters of the nonlinear model to guarantee numerical stability. 2) Brox's coarse-to-fine warping optical flow technique was employed to automatically track the region of interest located inside the myocardial area to ensure the accuracy of the quantitative analysis. Finally, we illustrate some examples of clinical studies to indicate the effectiveness of the system and the reliability of the methods.
Collapse
Affiliation(s)
- Feng-rong Sun
- School of Information Science and Engineering, Shandong University, Jinan 250100, China.
| | | | | | | | | | | |
Collapse
|
16
|
Bertini M, Valzania C, Biffi M, Martignani C, Ziacchi M, Pedri S, Domenichini G, Diemberger I, Saporito D, Rocchi G, Rapezzi C, Branzi A, Boriani G. Interventricular Delay Optimization: A Comparison among Three Different Echocardiographic Methods. Echocardiography 2010; 27:38-43. [DOI: 10.1111/j.1540-8175.2009.00975.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
17
|
Region of Interest Tracking in Real-Time Myocardial Contrast Echocardiography. J Med Syst 2009; 35:163-7. [DOI: 10.1007/s10916-009-9353-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Accepted: 07/15/2009] [Indexed: 10/20/2022]
|
18
|
Zwirn G, Beeri R, Gilon D, Friedman Z, Akselrod S. Quantitative evaluation of local myocardial blood volume in contrast echocardiography. Med Image Anal 2009; 13:62-79. [DOI: 10.1016/j.media.2008.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Revised: 03/21/2008] [Accepted: 06/16/2008] [Indexed: 11/26/2022]
|
19
|
Zwirn G, Beeri R, Gilon D, Akselrod S. Automatic Endocardial-Boundary Detection in Low Mechanical-Index Contrast Echocardiography. IEEE Trans Biomed Eng 2006; 53:2310-22. [PMID: 17073337 DOI: 10.1109/tbme.2006.883699] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper presents a novel algorithm, aimed at automatic endocardial boundary (inner boundary) detection in myocardial opacification scenarios. The data acquisition protocol uses (on purpose) low mechanical index imaging (i.e., weak ultrasound signal), so that the acquired images are characterized by low signal-to-noise ratios. The proposed algorithm is based on converting the frames, given in Cartesian coordinates, into polar coordinates, and applying a set of filters in order to compute the initial estimation of the endocardial boundary. The final estimation of the endocardial boundary is produced by an error correction process, which uses both spatial and temporal filtering. The estimated boundaries are converted into Cartesian coordinates, for display. Our algorithm has been tested on nine cine-loops. The resulting myocardial outlines have been separately assessed by two clinicians, scoring each segment in each cine-loop on a scale between 5 (excellent) and 1 (completely unacceptable). The mean overall score is 3.8 +/- 0.8, which seems adequate. The same clinicians have also manually drawn the contours of the endocardial boundary for the end-systolic and the end-diastolic frames of each cine-loop. The results show, that the mismatch between the automatically determined outlines and the manually drawn outlines is of the same order of magnitude as the interobserver variability. These results further support the validity of our method.
Collapse
Affiliation(s)
- Gil Zwirn
- Abramson Center of Medical Physics, Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978, Israel.
| | | | | | | |
Collapse
|