Assessment of transmitral and left atrial appendage flow rate from cardiac 4D-CT

Figures

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  Fig. 1. Registration Workflow. a The Source surface at 0%RR was registered onto the target surfaces at 5%RR and 95%RR. The resulting final registrations were then registered onto 10%RR and 90%RR, respectively. The surface of the LAA (marked blue and green) was registered separately. b The registration was driven by four different terms: Landmark, Stiffness, Distance and Bi-directional.

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  Fig. 2. Evaluation of distance between registration and target surface. a Boxplot diagrams of distance between registration and target surface. The central mark indicates the median, bottom and top edges of the box indicate the 25th and 75th percentiles, respectively. The whiskers extend to the most extreme data points not considered outliers, and the outliers are not shown for better visibility. b Visualizations of the distance from registration to target in 3 patients.

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  Fig. 3. Mitral Valve Flow. a Flow thought Mitral Valve calculated based on 4D flow MRI and time resolved CT, Early Diastolic Peak Flow is marked with x, and Late Diastolic Peak Flow is marked with o. b Comparison of MV flow parameters: Time Span Between Peaks, Ventricular Stroke Volume, Early Diastolic Peak Flow, Late Diastolic Peak Flow, and Ef/Af ratio in 4D flow MRI and 4D CT. Top: Solid line indicates Linear Regression line; Dotted lines indicate 95% confidence bounds; Dashed line indicates identity line. The box shows the linear regression equation and the coefficient of determination R2. Bottom: Bland-Altman Plot; Solid line indicates the bias, Dashed lines indicate ±1.96 standard deviation.

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  Fig. 4. Comparison of Ventricular Stroke Volume measured with CT, 4D flow MRI and Short Axis MRI. In the comparison of CT and Short Axis MRI, the differences between the measurements were not normal distributed, so the limits of agreement might be overestimated Top: Solid line indicates Linear Regression line; Dotted lines indicate 95% confidence bounds; Dashed line indicates identity line. The box shows the linear regression equation and the coefficient of determination R2. Bottom: Bland-Altman Plot; Solid line indicates the bias, Dashed lines indicate ±1.96 standard deviation.

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  Fig. 5. LAA Flow Rate. a Flow rate though LAA orifice calculated based on 4D flow MRI and time resolved CT, peak LAA outflow is marked with X. b Comparison of Peak LAA Outflow Rate in 4D flow MRI and 4D CT. Top: Linear Regression: Solid line indicates Linear Regression line; Dotted lines indicate 95% confidence bounds; Dashed line indicates identity line. The box shows the linear regression equation and the coefficient of determination R2. Bottom Bland-Altman Plot, Solid line indicates the bias, Dashed lines indicate ±1.96 standard deviation.