New Solution for Segmental Assessment of Left Ventricular Wall Thickness, Using Anatomically Accurate and Highly Reproducible Automated Cardiac MRI Software

Figures

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  Figure 1. CMR contouring on short axis (SAX) images using the MassK algorithm for the assessment of volumetric, functional and myocardial mass parameters. The light green circle indicates the epicardial-, the red circle refers to the endocardial boundary; the dark green area between the contours represents the compact myocardium. The entire dark green area within the endocardial border highlights the trabeculated and papillary muscle.

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  Figure 2. (A): Manual distance measurement on the LAX 3 chamber image. Yellow lines represent individually measured wall thickness of each segment. (B): Bullseye plot of the LV with the modified 16-segment model. The blue segments represent the 2-cavity plane, the yellow segments represent the 3-cavity plane and the red segments represent the 4-cavity plane. The orange areas indicate regions that belong to both the 3- and 4-cavity areas. Sg.: Segments, the black arrow represents the anterior wall.

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  Figure 3. Contour preparation for OptiLayer analysis. The green circle indicates the epicardial-, the red circle refers to the endocardial boundary. The red arrow indicates the aligned epicardial and endocardial contours at the apex of the heart, which represents the origin of the wall thickness analysis from the apical to the basal segments (white arrows).

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  Figure 4. (A): Visual representation of the OptiLayer method in schematic chart. The red line indicates the endocardial-, the green line shows the epicardial contours. The dark green area represents the left ventricular wall. 1: Detection of the cardiac apex; 2: Measurement direction from the base through the apex to the contralateral base. The gray lines indicate the automated measurement between the epicardial and endocardial contours; 3: The sequence based on the 100 auto-measured wall distances. Values close to zero indicate the cardiac apex, which is detected by the OptiLayer. 4: Accurate wall thickness assessment based on anatomical segmentation. The measurement series from the apex to the base is divided into three parts, yielding the wall thicknesses of the basal, mid, and apical segments. RA: right atrium; LA: left atrium; RV: right ventricle; LV: left ventricle; s17: segment 17; Basal: basal third; Mid: middle third; Apical: apical third. (B): Front end of the OptiLayer program. This screenshot shows the user surface in use, after loading the images, as shown in the left gray panel with test patients. The numbers on the bullseye LV model represent the wall thickness of each…