A novel automatic 3D+time left ventricle (LV) segmentation framework is proposed for cardiac magnetic resonance (CMR) datasets. The proposed framework consists of three conceptual blocks to delineate both endo and epicardial contours throughout the cardiac cycle: (1) an automatic 2D mid-ventricular initialization and segmentation; (2) an automatic stack initialization followed by a 3D segmentation at the end-diastolic phase; and (3) a tracking procedure. Hereto, we propose to adapt the recent B-spline Explicit Active Surfaces (BEAS) framework to the properties of CMR images by integrating dedicated energy terms. Moreover, we extend the coupled BEAS formalism towards its application in 3D MR data by adapting it to a cylindrical space suited to deal with the topology of the image data. Furthermore, a fast stack initialization method is presented for efficient initialization and to enforce consistent cylindrical topology. Finally, we make use of an anatomically constrained optical flow method for temporal tracking of the LV surface. The proposed framework has been validated on 45 CMR datasets taken from the 2009 MICCAI LV segmentation challenge. Results show the robustness, efficiency and competitiveness of the proposed method both in terms of accuracy and computational load.

The purpose of this study is to assess, with elite crawl swimmers, the time limit at the minimum velocity corresponding to maximal oxygen consumption (TLim-vVO2max), and to characterize its main determinants. Eight subjects performed an incremental test for vVO2max assessment and, forty-eight hours later, an all-out swim at vVO2max until exhaustion. VO2 was directly measured using a telemetric portable gas analyzer and a visual pacer was used to help the swimmers keeping the predetermined velocities. Blood lactate concentrations, heart rate and stroke parameter values were also measured. TLim-vVO2max and vVO2max, averaged, respectively, 243.2 +/- 30.5 s and 1.45 +/- 0.08 m . s (-1). TLim-vVO2max correlated positively with VO2 slow component (r = 0.76, p < 0.05). Negative correlations were found between TLim-vVO2max and body surface area (r = - 0.80) and delta lactate (r = - 0.69) (p < 0.05), and with vVO2max (r = - 0.63), v corresponding to anaerobic threshold (r = - 0.78) and the energy cost corresponding to vVO2max (r = - 0.62) (p < 0.10). No correlations were observed between TLim-vVO2max and stroking parameters. This study confirmed the tendency to TLim-vVO2max be lower in the swimmers who presented higher vVO2max and vAnT, possibly explained by their higher surface area, energy cost and anaerobic rate. Additionally, O2SC seems to be a determinant of TLim-vVO2max.

BackgroundCardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a promising technique for quantification of myocardial strain from steady-state free precession (SSFP) cine images. We sought to determine the variability of CMR-FT using a non-rigid elastic registration algorithm recently available in a commercial software package (Segment, Medviso) in a real-life clinical setting.MethodsFirstly, we studied the variability in a healthy volunteer who underwent 10 CMR studies over five consecutive days. Secondly, 10 patients were selected from our CMR database yielding normal findings (normal group). Finally, we prospectively studied 10 patients with known or suspected myocardial pathology referred for further investigation to CMR (patient group). In the patient group a second study was performed respecting an interval of 30 min between studies. All studies were manually segmented at the end-diastolic phase by three observers. In all subjects left ventricular (LV) circumferential and radial strain were calculated in the short-axis direction (EccSAX and ErrSAX, respectively) and longitudinal strain in the long-axis direction (EllLAX). The level of CMR experience of the observers was 2 weeks, 6 months and >20 years.ResultsMean contouring time was 7 ± 1 min, mean FT calculation time 13 ± 2 min. Intra- and inter-observer variability was good to excellent with an coefficient of reproducibility (CR) ranging 1.6% to 11.5%, and 1.7% to 16.0%, respectively and an intraclass correlation coefficient (ICC) ranging 0.89 to 1.00 and 0.74 to 0.99, respectively. Variability considerably increased in the test-retest setting with a CR ranging 4.2% to 29.1% and an ICC ranging 0.66 to 0.95 in the patient group. Variability was not influenced by level of expertise of the observers. Neither did the presence of myocardial pathology at CMR negatively impact variability. However, compared to global myocardial strain, segmental myocardial strain variability increased with a factor 2–3, in particular for the basal and apical short-axis slices.ConclusionsCMR-FT using non-rigid, elastic registration is a reproducible approach for strain analysis in patients routinely scheduled for CMR, and is not influenced by the level of training. However, further improvement is needed to reliably depict small variations in segmental myocardial strain.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-017-0333-y) contains supplementary material, which is available to authorized users.