Quantitative Mitral Valve Modeling Using Real-Time Three-Dimensional Echocardiography: Technique and Repeatability

被引:54
作者
Jassar, Arminder Singh
Brinster, Clayton J.
Vergnat, Mathieu
Robb, J. Daniel
Eperjesi, Thomas J.
Pouch, Alison M.
Cheung, Albert T.
Weiss, Stuart J.
Acker, Michael A.
Gorman, Joseph H., III
Gorman, Robert C.
Jackson, Benjamin M.
机构
[1] Univ Penn, Dept Surg, Philadelphia, PA 19104 USA
[2] Univ Penn, Dept Anesthesia, Philadelphia, PA 19104 USA
[3] Univ Penn, Gorman Cardiovasc Res Grp, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
2-DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY; LEAFLET CURVATURE; REGURGITATION; ANNULOPLASTY; REPAIR; PROLAPSE; LOCALIZATION; METHODOLOGY;
D O I
10.1016/j.athoracsur.2010.10.034
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Real-time three-dimensional (3D) echocardiography has the ability to construct quantitative models of the mitral valve (MV). Imaging and modeling algorithms rely on operator interpretation of raw images and may be subject to observer-dependent variability. We describe a comprehensive analysis technique to generate high-resolution 3D MV models and examine interoperator and intraoperator repeatability in humans. Methods. Patients with normal MVs were imaged using intraoperative transesophageal real-time 3D echocardiography. The annulus and leaflets were manually segmented using a TomTec Echo-View workstation. The resultant annular and leaflet point cloud was used to generate fully quantitative 3D MV models using custom Matlab algorithms. Eight images were subjected to analysis by two independent observers. Two sequential images were acquired for 6 patients and analyzed by the same observer. Each pair of annular tracings was compared with respect to conventional variables and by calculating the mean absolute distance between paired renderings. To compare leaflets, MV models were aligned so as to minimize their sum of squares difference, and their mean absolute difference was measured. Results. Mean absolute annular and leaflet distance was 2.4 +/- 0.8 and 0.6 +/- 0.2 mm for the interobserver and 1.5 +/- 0.6 and 0.5 +/- 0.2 mm for the intraobserver comparisons, respectively. There was less than 10% variation in annular variables between comparisons. Conclusions. These techniques generate high-resolution, quantitative 3D models of the MV and can be used consistently to image the human MV with very small interoperator and intraoperator variability. These data lay the framework for reliable and comprehensive non-invasive modeling of the normal and diseased MV. (Ann Thorac Surg 2011; 91: 165-71) (C) 2011 by The Society of Thoracic Surgeons
引用
收藏
页码:165 / 171
页数:7
相关论文
共 27 条
[1]   STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT [J].
BLAND, JM ;
ALTMAN, DG .
LANCET, 1986, 1 (8476) :307-310
[2]   Mitral valve procedure in dilated cardiomyopathy:: Repair or replacement? [J].
Calafiore, AM ;
Gallina, S ;
Di Mauro, M ;
Gaeta, F ;
Iacò, AL ;
D'Alessandro, S ;
Mazzei, V ;
Di Giammarco, G .
ANNALS OF THORACIC SURGERY, 2001, 71 (04) :1146-1152
[3]   SYSTEM FOR ULTRASONICALLY IMAGING HUMAN HEART IN 3 DIMENSIONS [J].
DEKKER, DL ;
PIZIALI, RL ;
DONG, E .
COMPUTERS AND BIOMEDICAL RESEARCH, 1974, 7 (06) :544-553
[4]   Accurate Measurement of Mitral Annular Dimensions by Echocardiography: Importance of Correctly Aligned Imaging Planes and Anatomic Landmarks [J].
Foster, Gary P. ;
Dunn, Adam K. ;
Abraham, Selwin ;
Ahmadi, Naser ;
Sarraf, Guilda .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2009, 22 (05) :458-463
[5]   Three-dimensional versus two-dimensional transesophageal echocardiography in mitral valve repair [J].
Garcia-Orta, Rocio ;
Moreno, Eduardo ;
Vidal, Matilde ;
Ruiz-Lopez, Fuensanta ;
Oyonarte, Jose M. ;
Lara, Juan ;
Moreno, Teodoro ;
Garcia-Fernandezd, Miguel A. ;
Azpitarte, Jose .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2007, 20 (01) :4-12
[6]   Insights on left ventricular and valvular mechanisms of recurrent ischemic mitral regurgitation after restrictive annuloplasty and coronary artery bypass grafting [J].
Gelsomino, Sandro ;
Lorusso, Roberto ;
Caciolli, Sabina ;
Capecchi, Irene ;
Rostagno, Carlo ;
Chioccioli, Marco ;
De Cicco, Giuseppe ;
Bille, Giuseppe ;
Stefano, Pierluigi ;
Gensini, Gian Franco .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2008, 136 (02) :507-518
[7]   Annuloplasty ring selection for chronic ischemic mitral regurgitation: Lessons from the ovine model [J].
Gorman, JH ;
Gorman, RC ;
Jackson, BM ;
Enomoto, Y ;
St John-Sutton, MG ;
Edmunds, LH .
ANNALS OF THORACIC SURGERY, 2003, 76 (05) :1556-1563
[8]   Real-Time Three-Dimensional Transesophageal Echocardiography in the Intraoperative Assessment of Mitral Valve Disease [J].
Grewal, Jasmine ;
Mankad, Sunil ;
Freeman, William K. ;
Click, Roger L. ;
Suri, Rakesh M. ;
Abel, Martin D. ;
Oh, Jae K. ;
Pellikka, Patricia A. ;
Nesbitt, Gillian C. ;
Syed, Imran ;
Mulvagh, Sharon L. ;
Miller, Fletcher A. .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2009, 22 (01) :34-41
[9]   Transthoracic real-time three-dimensional echocardiography offers additional value in the assessment of mitral valve morphology and area following mitral valve repair [J].
Hoole, Stephen P. ;
Liew, Tze V. ;
Boyd, James ;
Wells, Francis C. ;
Rusk, Rosemary A. .
EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY, 2008, 9 (05) :625-630
[10]   3D echocardiography: A review of the current status and future directions [J].
Hung, Judy ;
Lang, Roberto ;
Flachskampf, Frank ;
Shernan, Stanton K. ;
McCulloch, Marti L. ;
Adams, David B. ;
Thomas, James ;
Vannan, Mani ;
Ryan, Thomas .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2007, 20 (03) :213-233