Bersvendsen Jørn, Beitnes Jan O, Urheim Stig, Aakhus Svend, Samset Eigil
GE Vingmed Ultrasound AS, Horten, Norway.
BMC Med Imaging. 2014 Sep 8;14:31. doi: 10.1186/1471-2342-14-31.
Transcatheter aortic valve implantation involves percutaneously implanting a biomechanical aortic valve to treat severe aortic stenosis. In order to select a proper device, precise sizing of the aortic valve annulus must be completed.
In this paper, we describe a fully automatic segmentation method to measure the aortic annulus diameter in patients with aortic calcification, operating on 3-dimensional transesophageal echocardiographic images. The method is based on state estimation of a subdivision surface representation of the left ventricular outflow tract and aortic root. The state estimation is solved by an extended Kalman filter driven by edge detections normal to the subdivision surface.
The method was validated on echocardiographic recordings of 16 patients. Comparison against two manual measurements showed agreements (mean ±SD) of -0.3 ± 1.6 and -0.2 ± 2.3 mm for perimeter-derived diameters, compared to an interobserver agreement of -0.1 ± 2.1 mm.
With this study, we demonstrated the feasibility of an efficient and fully automatic measurement of the aortic annulus in patients with aortic disease. The algorithm robustly measured the aortic annulus diameter, providing measurements indistinguishable from those done by cardiologists.
经导管主动脉瓣植入术涉及经皮植入生物力学主动脉瓣以治疗严重主动脉瓣狭窄。为了选择合适的装置，必须完成主动脉瓣环的精确尺寸测量。
在本文中，我们描述了一种全自动分割方法，用于在患有主动脉钙化的患者中测量主动脉瓣环直径，该方法基于三维经食管超声心动图图像进行操作。该方法基于左心室流出道和主动脉根部细分曲面表示的状态估计。状态估计通过由垂直于细分曲面的边缘检测驱动的扩展卡尔曼滤波器来求解。
该方法在16例患者的超声心动图记录上得到验证。与两种手动测量方法相比，周长衍生直径的一致性（均值±标准差）分别为-0.3±1.6毫米和-0.2±2.3毫米，而观察者间一致性为-0.1±2.1毫米。
通过本研究，我们证明了对患有主动脉疾病的患者进行高效且全自动测量主动脉瓣环的可行性。该算法能够稳健地测量主动脉瓣环直径，提供与心脏病专家测量结果难以区分的测量值。
