Fast automatic measurement of mitral annulus excursion using a pocket-sized ultrasound system.

We present a fast, automatic method for mitral annulus excursion measurement using pocket-sized ultrasound (PSU). The motivation is to provide PSU users with a rapid measurement of cardiac systolic function. The algorithm combines low-frame-rate tolerance, computational efficiency and automation in a novel way. The method uses a speckle-tracking scheme, initialized and constrained by a deformable model. A feasibility study using 30 apical four-chamber PSU recordings from an unselected patient population revealed an error of (mean ± SD) -1.80 ± 1.96 mm, p < 0.001, when compared with manual anatomic m-mode analysis using laptop scanner data. When only septal side excursion was measured, the mean error was -0.27 ± 1.89 mm, p < 0.001. The accuracy is comparable with previously reported results using semiautomatic methods and full-size scanners. The computation time of 3.7 ms/frame on a laptop computer suggests that a real-time implementation on a PSU device is feasible.

[1]  Alan H. Barr,et al.  Global and local deformations of solid primitives , 1984, SIGGRAPH.

[2]  W. Culp,et al.  The Pocket Echocardiograph: Validation and Feasibility , 2010, Echocardiography.

[3]  Nico de Jong,et al.  Automated tracking of the mitral valve annulus motion in apical echocardiographic images using multidimensional dynamic programming. , 2007, Ultrasound in medicine & biology.

[4]  Hirotsugu Yamada,et al.  Automated mitral annular tracking: a novel method for evaluating mitral annular motion using two-dimensional echocardiography. , 2005, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[5]  D. Spevack,et al.  Hand Carried Echocardiography in the Critical Care Setting , 2003, Echocardiography.

[6]  Victor Mor-Avi,et al.  Rapid estimation of left ventricular function using echocardiographic speckle-tracking of mitral annular displacement. , 2010, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[7]  J. Alison Noble,et al.  A shape-space-based approach to tracking myocardial borders and quantifying regional left-ventricular function applied in echocardiography , 2002, IEEE Transactions on Medical Imaging.

[8]  Gabriel Kiss,et al.  Real-time Left Ventricular Speckle-Tracking in 3D Echocardiography With Deformable Subdivision Surfaces , 2008 .

[9]  Andrew Blake,et al.  Evaluating a robust contour tracker on echocardiographic sequences , 1999, Medical Image Anal..

[10]  J. Atherton.  Screening for left ventricular systolic dysfunction: is imaging a solution? , 2010, JACC. Cardiovascular imaging.

[11]  Eran Toledo,et al.  Evaluation of left ventricular systolic function using automated angle-independent motion tracking of mitral annular displacement. , 2005, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[12]  Fredrik Orderud,et al.  Real-time 3D segmentation of the left ventricle using deformable subdivision surfaces , 2008, 2008 IEEE Conference on Computer Vision and Pattern Recognition.

[13]  J. Cleland,et al.  Reliability of reporting left ventricular systolic function by echocardiography: a systematic review of 3 methods. , 2003, American heart journal.

[14]  B. Wandt,et al.  The relation between mitral annulus motion and ejection fraction: a nonlinear function. , 2000, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[15]  K. Spencer.  Hand-carried cardiac ultrasound , 2008 .

[16]  Mitral annular motion as a surrogate for left ventricular function: correlation with brain natriuretic peptide levels. , 2006 .

[17]  A. Ionescu,et al.  The pocket echocardiograph: a useful new tool? , 2008, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[18]  Michael Isard,et al.  Learning to Track the Visual Motion of Contours , 1995, Artif. Intell..

[19]  J. Noble,et al.  Quantitative regional analysis of myocardial wall motion. , 2001, Ultrasound in medicine & biology.

[20]  Andrew Blake,et al.  A framework for spatiotemporal control in the tracking of visual contours , 1993, International Journal of Computer Vision.

[21]  Lars-Ake Brodin,et al.  Analysis of mitral annulus motion measurements derived from M-mode, anatomic M-mode, tissue Doppler displacement, and 2-dimensional strain imaging. , 2006, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[22]  Jeroen J. Bax,et al.  Screening for left ventricular dysfunction using a hand‐carried cardiac ultrasound device , 2003, European journal of heart failure.

[23]  Raimund Erbel,et al.  Hand-carried cardiac ultrasound (HCU) device: recommendations regarding new technology. A report from the Echocardiography Task Force on New Technology of the Nomenclature and Standards Committee of the American Society of Echocardiography. , 2002, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[24]  B. Wandt,et al.  The relation between mitral annulus motion and ejection fraction changes with age and heart size. , 2000, Clinical physiology.