Semiautomatic Detection of Myocardial Contours in Order to Investigate Normal Values of the Left Ventricular Trabeculated Mass Using MRI

Purpose: To propose, assess, and validate a semiautomatic method allowing rapid and reproducible measurement of trabeculated and compacted left ventricular (LV) masses from cardiac magnetic resonance imaging (MRI). Materials and Methods: We developed a method to automatically detect noncompacted, endocardial, and epicardial contours. Papillary muscles were segmented using semiautomatic thresholding and were included in the compacted mass. Blood was removed from trabeculae using the same threshold tool. Trabeculated, compacted masses and ratio of noncompacted to compacted (NC:C) masses were computed. Preclinical validation was performed on four transgenic mice with hypertrabeculation of the LV (high-resolution cine imaging, 11.75T). Then analysis was performed on normal cine-MRI examinations (steady-state free precession [SSFP] sequences, 1.5T or 3T) obtained from 60 healthy participants (mean age 49 +/- 16 years) with 10 men and 10 women for each of the following age groups: [20,39], [40,59], and [60,79]. Interobserver and interexamination segmentation reproducibility was assessed by using Bland-Altman analysis and by computing the correlation coefficient. Results: In normal participants, noncompacted and compacted masses were 6.29 +/- 2.03 g/m(2) and 62.17 +/- 11.32 g/m(2), respectively. The NC: C mass ratio was 10.26 +/- 3.27%. Correlation between the two observers was from 0.85 for NC: C ratio to 0.99 for end-diastolic volume (P < 10(-5)). The bias between the two observers was -1.06 +/- 1.02 g/m(2) for trabeculated mass, -1.41 +/- 2.78 g/m(2) for compacted mass, and -1.51 +/- 1.77% for NC: C ratio. Conclusion: We propose a semiautomatic method based on region growing, active contours, and thresholding to calculate the NC: C mass ratio. This method is highly reproducible andmight help in the diagnosis of LV noncompaction cardiomyopathy.