Blanchard, Cédric

Bouchot, Olivier

Lalande, Alain

Mohan, Pauliah

Sliwa, Tadeusz

Steinmetz, Eric

Voisin, Yvon

English

PubMed

Cédric Blanchard

Tadeusz Sliwa

Alain Lalande

Eric Steinmetz

Pauliah Mohan

Olivier Bouchot

Yvon Voisin

Springer - Publisher Connector

POSTER PRESENTATION Open Access
Automatic evaluation of the sinus of Valsalva
from cine-MRI in patients with dilated aortic root
Cédric Blanchard1*, Tadeusz Sliwa1, Alain Lalande1, Eric Steinmetz2, Pauliah Mohan1, Olivier Bouchot2, Yvon Voisin1
From 2011 SCMR/Euro CMR Joint Scientific Sessions
Nice, France. 3-6 February 2011
Purpose
MRI appears to be particularly attractive for the study of
the sinus of Valsalva (SV), however there is no global
consensus on their measurements. The purpose of this
study is to automatically evaluate the SV from cross-sec-
tional cine-MR images and show that in this suitable
plane diagnostic evaluation such as SV dilatation can be
performed from the determination of the maximal
radius.
Methods
Cine-MR images were acquired using a breath-hold
ECG-gated steady-state free-precession sequence (TR =
1.54 ms, TE = 1.49 ms, 17 lines per segment, a = 65°,
slice thickness = 5 mm, temporal resolution = 27 msec/
images, spatial resolution varied from 0.7 mm to 1.6
mm per pixel, according to the patient examination).
The acquisition plane was oriented in aortic valve cross-
section. Manual processing on the whole images
remains a reliable but time-consuming solution. Then,
an automatic method based on mathematical morphol-
ogy, combining numerical geodesic reconstruction with
RANSAC method to estimate area was elaborated in
order to segment the aortic root. Relevant points, such
as the commissures, the cusps and the centre of the SV
are also automatically detected by using a distance
transform for centre estimation and a radial study to
find extremum radii points. Our method was tested on
13 examinations of patients with SV dilatation (2
women and 11 men, age: 54±11 years, body surface
area: 1.97±0.19 m2). Considering all images, the maxi-
mum distance between two cusps determines the maxi-
mum radius. Manual measurement of this parameter
was made by an experienced observer.
Results
There is an excellent correlation between manual and
automatic measurements (r= 0.93; y = 0.93 x + 4.0;
p<10-3). The corresponding Bland-Altman study shows
an excellent concordance between the two approaches
(mean of the differences = 0.5 mm and standard devia-
tion of the differences = 2.3 mm). Figure 1.
1LE2I UMR5158, Auxerre, France
Full list of author information is available at the end of the article
Figure 1 a) Segmentation on a whole image sequence with SV
shape (yellow), centre (green), cups (red) and commissures (blue). b)
Different measures on diastolic and systolic images.
Blanchard et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P356
http://jcmr-online.com/content/13/S1/P356
© 2011 Blanchard et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Conclusions
Hence the cross-sectional orientation of the image
acquisition plane combined with an automatic method
provides reliable SV dilatation diagnosis, in particular by
an automatic evaluation of the maximum diameter that
is a crucial parameter in the follow-up of these patients.
Moreover, the choice of this plane renders this evalua-
tion robust in the case of the asymmetric dilatation and
allows specifying the diagnosis because all distance
between the cups, the commissures and the centre are
available.
Author details
1LE2I UMR5158, Auxerre, France. 2Service de Chirurgie Cardio-Vasculaire, CHU
Dijon, Dijon, France.
Published: 2 February 2011
doi:10.1186/1532-429X-13-S1-P356
Cite this article as: Blanchard et al.: Automatic evaluation of the sinus of
Valsalva from cine-MRI in patients with dilated aortic root. Journal of
Cardiovascular Magnetic Resonance 2011 13(Suppl 1):P356.
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Blanchard et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P356
http://jcmr-online.com/content/13/S1/P356
Page 2 of 2


Automatic evaluation of the sinus of Valsalva from cine-MRI in patients with dilated aortic root

Crossref

Journal of Cardiovascular Magnetic Resonance

Bouchot Olivier

Mohan Pauliah

Steinmetz Eric

Lalande Alain

Sliwa Tadeusz

Blanchard Cédric

Voisin Yvon

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Automatic evaluation of the sinus of Valsalva from cine-MRI in patients with dilated aortic root

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