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: Els canvis en la dinàmica del Ventricle Esquerre (VE) reflecteixen la majoria de malalties cardiovasculars . Els avenços en imatge mèdica han impulsat la recerca en models i simulacions de la dinàmica 3D del VE . La majoria dels models existents sols consideren l’anatomia externa del VE i no permeten una avaluació de l’acoblament electromecànic . Donat que la mecànica d’un muscle depèn de la orientació de les seves fibres, un model realista hauria d’incloure la disposició espacial de la banda ventricular helicoidal (BVH) .
Proposem desenvolupar un model del VE adaptat a cada pacient que integri, per primer cop, l’anatomia de la banda ventricular, l’anatomia externa del VE i la seva funcionalitat, per a una millor determinació del patró d’activació electromecànica

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: Regional scores (e.g. strain, perfusion) of the Left Ventricle (LV) functionality are playing an increasing role in the diagnosis of cardiac diseases. A main limitation is the lack of normality models for complementary scores oriented to assessment of the LV integrity. This paper introduces an original framework based on a parametrization of the LV domain, which allows comparison across subjects of local physiological measures of different nature. We compute regional normality patterns in a feature space characterizing the LV function. We show the consistency of the model for the regional motion on healthy and hypokinetic pathological cases

Abstract: Medical imaging is very useful in the assessment and treatment of many diseases. To deal with the great amount of data provided by imaging scanners and extract quantitative information that physicians can interpret, many analysis algorithms have been developed. Any process of analysis always consists of a first step of segmenting some particular structure. In medical imaging, structures are not always well defined and suffer from noise artifacts thus, ordinary segmentation methods are not well suited. The ones that seem to give better results are those based on deformable models. Nevertheless, despite their capability of mixing image features together with smoothness constraints that may compensate for image irregularities, these are naturally local methods, i. e., each node of the active contour evolve taking into account information about its neighbors and some other weak constraints about flexibility and smoothness, but not about the global shape that they should find. Due to the fact that structures to be segmented are the same for all cases but with some inter and intra-patient variation, the incorporation of a priori knowledge about shape in the segmentation method will provide robustness to it. Active Shape Models is an algorithm based on the creation of a shape model called Point Distribution Model. It performs a segmentation using only shapes similar than those previously learned from a training set that capture most of the variation presented by the structure. This algorithm works by updating shape nodes along a normal segment which often can be too restrictive. For this reason we propose a generalization of this algorithm that we call Generalized Active Shape Models and fully integrates the a priori knowledge given by the Point Distribution Model with deformable models or any other appropriate segmentation method. Two different applications to cardiac imaging of this generalized method are developed and promising results are shown.