Preprocedural magnetic resonance imaging for image-guided catheter ablation of scar-related ventricular tachycardia.
Int J Cardiovasc Imaging
; 31(2): 369-77, 2015 Feb.
Article
em En
| MEDLINE
| ID: mdl-25341408
ABSTRACT
To present and validate a highly automated MRI analysis workflow for image-guided catheter ablation of scar-related ventricular tachycardia (VT) ablation procedures. A cohort of 15 post-infarction patients underwent MRI prior to VT ablation. The MRI study included a black-blood turbo spin echo sequence for visualizing the aortic root and ostium of the left main (LM) coronary artery, and a 3D late gadolinium enhanced sequence for visualizing the LV anatomy and myocardial scar substrate. Semi-automated segmentation of the LV, aortic root and ostium of LM was performed, followed by fully automated segmentation of myocardial scar. All segmented structures were aligned using an automated image registration algorithm to remove inter-scan displacement. MRI was integrated at the beginning of the procedure after mapping a single LM point. The integration performance was compared to that of the traditional iterative closest point (ICP) method. The proposed method required a single LM mapping point only, compared to 255 ± 43 points with the ICP method. The single-point method achieved a mean point-to-surface distance of 4.9 ± 1.5 mm on the LV surface and 5.1 ± 1.7 mm on the aorta surface (ICP 3.7 ± 0.8 and 9.2 ± 7.2 mm, P < 0.05). The Cohen's kappa coefficient between the MRI-defined and EAM-defined scar was 0.36 ± 0.16 for the presented method, significantly higher than that of ICP method (0.23 ± 0.21, P = 0.03), indicating more accurate scar substrate localization during integration. This study demonstrated the feasibility of preprocedural MRI integration into the VT ablation procedure, with highly automated image analysis workflow and minimal mapping effort.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cicatriz
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Taquicardia Ventricular
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Ablação por Cateter
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Imagem Cinética por Ressonância Magnética
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Cirurgia Assistida por Computador
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Infarto do Miocárdio
/
Miocárdio
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article