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首页> 外文期刊>IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control >Semiautomatic Estimation of Device Size for Left Atrial Appendage Occlusion in 3-D TEE Images
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Semiautomatic Estimation of Device Size for Left Atrial Appendage Occlusion in 3-D TEE Images

机译：3-D TEE图像中左心耳附件阻塞的设备大小的半自动估计

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摘要

Left atrial appendage (LAA) occlusion is used to reduce the risk of thromboembolism in patients with non-valvular atrial fibrillation by obstructing the LAA through a percutaneously delivered device. Nonetheless, correct device sizing is complex, requiring the manual estimation of different measurements in preprocedural/periprocedural images, which is tedious and time-consuming and with high interobserver and intraobserver variability. In this paper, a semiautomatic solution to estimate the required relevant clinical measurements is described. This solution starts with the 3-D segmentation of the LAA in 3-D transesophageal echocardiographic images, using a constant blind-ended model initialized through a manually defined spline. Then, the segmented LAA surface is aligned with a set of templates, i.e., 3-D surfaces plus relevant measurement planes (manually defined by one observer), transferring the latter to the unknown situation. Specifically, the alignment is performed in three consecutive steps, namely: 1) rigid alignment using the LAA clipping plane position; 2) orientation compensation using the circumflex artery location; and 3) anatomical refinement through a weighted iterative closest point algorithm. The novel solution was evaluated in a clinical database with 20 volumetric TEE images. Two experiments were set up to assess: 1) the sensitivity of the model's parameters and 2) the accuracy of the proposed solution for the estimation of the clinical measurements. Measurement levels manually identified by two observers were used as ground truth. The proposed solution obtained results comparable to the interobserver variability, presenting narrower limits of agreement for all measurements. Moreover, this solution proved to be fast, taking nearly 40 s (manual analysis took 3 min) to estimate the relevant measurements while being robust to the variation of the model's parameters. Overall, the proposed solution showed its potential for fast and robust estimation of the clinical measurements for occluding device selection, proving its added value for clinical practice.
机译：左心耳（LAA）封堵可通过经皮输送的装置阻塞LAA，从而降低非瓣膜性房颤患者的血栓栓塞风险。但是，正确的设备尺寸非常复杂，需要在手术前/手术前图像中手动估算不同的测量值，这既繁琐又费时，并且观察者之间和观察者内部差异很大。在本文中，描述了一种估计所需的相关临床测量值的半自动解决方案。该解决方案使用通过手动定义的样条曲线初始化的恒定盲端模型，在3D经食道超声心动图图像中对LAA进行3D分割。然后，将分段的LAA表面与一组模板对齐，即3-D表面加上相关的测量平面（由一个观察者手动定义），将后者转移到未知情况。具体地，对准是在三个连续的步骤中执行的，即：1）使用LAA剪切平面位置的刚性对准； 2）使用回旋动脉位置进行方向补偿； 3）通过加权迭代最近点算法进行解剖细化。在临床数据库中用20张体积TEE图像评估了该新型解决方案。建立了两个实验以评估：1）模型参数的敏感性，以及2）所提出的用于估计临床测量值的解决方案的准确性。由两名观察员手动确定的测量水平用作基本事实。提出的解决方案获得了与观察者间可变性相当的结果，为所有测量提供了较窄的一致性极限。此外，该解决方案被证明是快速的，花费了将近40 s（手动分析花费了3分钟）来估计相关测量值，同时对模型参数的变化具有鲁棒性。总体而言，所提出的解决方案显示出其潜力，可以快速，可靠地估计用于封闭设备选择的临床测量，证明了其在临床实践中的附加价值。

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    Morais Pedro; Vilaca Joao L.; Queiros Sandro; De Meester Pieter; Budts Werner; Tavares Joao Manuel R. S.; Dhooge Jan;

  • 作者单位

    Katholieke Univ Leuven, Dept Cardiovasc Sci, Lab Cardiovasc Imaging & Dynam, B-3000 Leuven, Belgium|Univ Minho, Sch Med, Life & Hlth Sci Res Inst ICVS, P-4710057 Braga, Portugal|Univ Minho, ICVS 3Bs PT Govt Associate Lab, P-4710057 Braga, Portugal|Univ Porto, Inst Ciencia & Inovacao Engn Mecan & Engn Ind, Fac Engn, Dept Engn Mecan, P-4150177 Porto, Portugal|2Ai Polytech Inst Cavado & Ave, P-4750810 Barcelos, Portugal;

    Univ Minho, ICVS 3Bs PT Govt Associate Lab, P-4710057 Braga, Portugal|2Ai Polytech Inst Cavado & Ave, P-4750810 Barcelos, Portugal|Univ Minho, Life & Hlth Sci Res Inst, P-4710057 Braga, Portugal;

    Katholieke Univ Leuven, Dept Cardiovasc Sci, Lab Cardiovasc Imaging & Dynam, B-3000 Leuven, Belgium|Univ Minho, ICVS 3Bs PT Govt Associate Lab, P-4710057 Braga, Portugal|Univ Minho, Life & Hlth Sci Res Inst, P-4710057 Braga, Portugal|Univ Minho, Algoritmi Ctr, P-4800058 Guimaraes, Portugal;

    Univ Hosp Leuven, Dept Cardiol, B-3000 Leuven, Belgium;

    Univ Hosp Leuven, Dept Cardiol, B-3000 Leuven, Belgium;

    Univ Porto, Inst Ciencia & Inovacao Engn Mecan & Engn Ind, Fac Engn, Dept Engn Mecan, P-4150177 Porto, Portugal;

    Katholieke Univ Leuven, Dept Cardiovasc Sci, Lab Cardiovasc Imaging & Dynam, B-3000 Leuven, Belgium;

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  • 正文语种 eng
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  • 关键词

    3-D image segmentation; 3-D transesophageal echocardiography; iterative closest point; left atrial appendage (LAA) occlusion; semiautomatic occluding device sizing;

    机译：3-D图像分割;3-D经细胞深呼超声造影;迭代最接近点;左心房附属物（LAA）闭塞;半自动闭塞装置尺寸;

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