Abstract: Impairment of left ventricular (LV) contractility due to cardiovascular diseases is reflected in LV motion patterns. The mechanics of any muscle strongly depends on the spatial orientation of its muscular fibers since the motion that the muscle undergoes mainly takes place along the fiber. The helical ventricular myocardial band (HVMB) concept describes the myocardial muscle as a unique muscular band that twists in space in a non homogeneous fashion. The 3D anisotropy of the ventricular band fibers suggests a regional analysis of the heart motion. Computation of normality models of such motion can help in the detection and localization of any cardiac disorder. In this paper we introduce, for the first time, a normalized parametric domain that allows comparison of the left ventricle motion across patients. We address, both, extraction of the LV motion from Tagged Magnetic Resonance images, as well as, defining a mapping of the LV to a common normalized domain. Extraction of normality motion patterns from 17 healthy volunteers shows the clinical potential of our LV parametrization.

Abstract: It is difficult to acquire tagged cardiac MR images with a high temporal and spatial resolution using clinical MR scanners. However, if such images are used for quantifying scores based on motion, it is essential a resolution as high as possible. This paper explores the influence of the temporal resolution of a tagged series on the quantification of myocardial dynamic parameters. To such purpose we have designed a SPAMM (Spatial Modulation of Magnetization) sequence allowing acquisition of sequences at simple and double temporal resolution. Sequences are processed to compute myocardial motion by an automatic technique based on the tracking of the harmonic phase of tagged images (the Harmonic Phase Flow, HPF). The results have been compared to manual tracking of myocardial tags. The error in displacement fields for double resolution sequences reduces 17%.

Abstract: The objective of this work is to segment the human left ventricle myocardium (LVM) in contrast echocardiography imaging and thus track it along a cardiac cycle in order to extract quantitative data about heart function. Ultrasound images are hard to work with due to their speckle appearance. To overcome this we report the combination of active contour models (ACM) or snakes and active shape models (ASM). The ability of ACM in giving closed and smooth curves in addition to the power of the ASM in producing shapes similar to the ones learned, evoke to a robust algorithm. Meanwhile the snake is attracted towards image main features, ASM acts as a correction factor. The algorithm was tested independently on 180 frames and satisfying results were obtained: in 95% the maximum difference between automatic and experts segmentation was less than 12 pixels.

Abstract: Cardiovascular Diseases, specially those affecting the Left Ventricle (LV), are the leading cause of death in developed countries with approximately a 30% of all global deaths. In order to address this public health concern, physicians focus on diagnosis and therapy planning. On one hand, early and accurate detection of Regional Wall Motion Abnormalities (RWMA) significantly contributes to a quick diagnosis and prevents the patient to reach more severe stages. On the other hand, a thouroughly knowledge of the normal gross anatomy of the LV, as well as, the distribution of its muscular fibers is crucial for designing specific interventions and therapies (such as pacemaker implanction). Statistical models obtained from the analysis of different imaging modalities allow the computation of the normal ranges of variation within a given population. Normality models are a valuable tool for the definition of objective criterions quantifying the degree of (anomalous) deviation of the LV function and anatomy for a given subject. The creation of statistical models involve addressing three main issues: extraction of data from images, definition of a common domain for comparison of data across patients and designing appropriate statistical analysis schemes. In this PhD thesis we present generic image processing tools for the creation of statistical models of the LV anatomy and function. On one hand, we use differential geometry concepts to define a computational framework (the Normalized Parametric Domain, NPD) suitable for the comparison and fusion of several clinical scores obtained over the LV. On the other hand, we present a variational approach (the Harmonic Phase Flow, HPF) for the estimation of myocardial motion that provides dense and continuous vector fields without overestimating motion at injured areas. These tools are used for the creation of statistical models. Regarding anatomy, we obtain an atlas jointly modelling, both, LV gross anatomy and fiber architecture. Regarding function, we compute normality patterns of scores characterizing the (global and local) LV function and explore, for the first time, the configuration of local scores better suited for RWMA detection.

Abstract: Cardiac magnetic resonance imaging (Cardiac MRI) has become a gold standard diagnostic technique for the assessment of cardiac mechanics, allowing the non-invasive calculation of left ventric- ular long axis longitudinal shortening (LVLS) and absolute myocardial torsion (AMT) between basal and apical left ventricular slices, a movement directly related to the helicoidal anatomic disposition of the myocardial fibers. The aim of this study is to determine AMT and LVLS behaviour and normal values from a group of healthy subjects. A group of 21 healthy volunteers (15 males) (age: 23–55 y.o., mean:30.7 ± 7.5) were prospectively included in an obser- vational study by Cardiac MRI. Left ventricular rotation (degrees) was calculated by custom-made software (Harmonic Phase Flow) in consecutive LV short axis planes tagged cine-MRI sequences. AMT was determined from the difference between basal and apical planes LV rotations. LVLS (%) was determined from the LV longitudinal and horizontal axis cine-MRI images. All the 21 cases studied were interpretable, although in three cases the value of the LV apical rotation could not be determined. The mean rotation of the basal and apical planes at end-systole were -3.71° ± 0.84° and 6.73° ± 1.69° (n:18) respectively, resulting in a LV mean AMT of 10.48° ± 1.63° (n:18). End-systolic mean LVLS was 19.07 ± 2.71%. Cardiac MRI allows for the calculation of AMT and LVLS, fundamental functional components of the ventricular twist mechanics conditioned, in turn, by the anatomical helical layout of the myocardial fibers. These values provide complementary information about systolic ventricular function in relation to the traditional parameters used in daily practice.