A Novel Skeleton Based Quantification and 3-D Volumetric Visualization of Left Atrium Fibrosis Using Late Gadolinium Enhancement Magnetic Resonance Imaging

作者：Ravanelli Daniele^*; dal Piaz Elena Costanza; Centonze Maurizio; Casagranda Giulia; Marini Massimiliano; Del Greco Maurizio; Karim Rashed; Rhode Kawal; Valentini Aldo

来源：IEEE Transactions on Medical Imaging, 2014, 33(2): 566-576.

DOI：10.1109/TMI.2013.2290324

• Atrial fibrosis
• electro-anatomical mapping systems
• late gadolinium enhancement magnetic resonance imaging (MRI)
• skeletonization
• three-dimensional (3-D) image processing

This work presents the results of a new tool for 3-D segmentation, quantification and visualization of cardiac left atrium fibrosis, based on late gadolinium enhancement magnetic resonance imaging (LGE-MRI), for stratifying patients with atrial fibrillation (AF) that are candidates for radio-frequency catheter ablation. In this study 10 consecutive patients suffering AF with different grades of atrial fibrosis were considered. LGE-MRI and magnetic resonance angiography (MRA) images were used to detect and quantify fibrosis of the left atriumusing a threshold and 2-D skeleton based approach. Quantification and 3-D volumetric views of atrial fibrosis were compared with quantification and 3-D bipolar voltage maps measured with an electro-anatomical mapping (EAM) system, the clinical reference standard technique for atrial substrate characterization. Segmentation and quantification of fibrosis areas proved to be clinically reliable among all different fibrosis stages. The proposed tool obtains discrepancies in fibrosis quantification less than 4% from EAM results and yields accurate 3-D volumetric views of fibrosis of left atrium. The novel 3-D visualization and quantification tool based on LGE-MRI allows detection of cardiac left atrium fibrosis areas. This noninvasive method provides a clinical alternative to EAM systems for quantification and localization of atrial fibrosis.

• 出版日期2014-2