Automatic identification of papillary muscles in left-ventricular short-axis echocardiographic images

• Published in: IEEE transactions on biomedical engineering 1996-05, Vol.43 (5), p.460-470
• Main Authors: Karras, T., Wilson, D.C., Geiser, E.A., Conetta, D.A.
• Format: Article
• Language: English
• Subjects: Algorithms; Backscatter; Biological and medical sciences; Biomedical imaging; Cardiology; Cardiovascular system; Cluster Analysis; Echocardiography - instrumentation; Echocardiography - methods; Echocardiography - statistics & numerical data; Heart; Heart Ventricles - diagnostic imaging; Humans; Image edge detection; Image sequences; Investigative techniques, diagnostic techniques (general aspects); Medical diagnostic imaging; Medical sciences; Motion estimation; Muscles; Observer Variation; Papillary Muscles - diagnostic imaging; Stroke Volume; Time Factors; Ultrasonic imaging; Ultrasonic investigative techniques
• ISSN: 0018-9294; 1558-2531
• DOI: 10.1109/10.488794

An automatic method for identifying the location of the papillary muscles in two-dimensional (2-D) short-axis echocardiographic images is described. The technique uses both spatial and temporal information to identify the presence and track the location of the muscles in the left ventricle from end-diastole to end-systole. The three main steps of the method are spatial preprocessing, spatial processing, and temporal processing. The spatial preprocessing step includes a region of search estimation. The spatial processing step includes a papillary muscle existence test and an initial approximation of the papillary muscle points. The temporal processing includes motion-pattern evaluation and final papillary muscle location, The estimates of existence and position for the automatic method were compared with estimates made by an independent expert observer. Two hundred and ten frames, three taken from each of 70 image sequences, were evaluated. Since two regions of search were processed for each frame (one for the posterior-inferior and one for the anterior-lateral papillary muscle), a total of 420 approximations were made. Of this total, 340 automatic estimates were judged to be in close agreement with estimates made by the expert. Of the remaining 80 approximations, 54 estimates were made by the expert when the computer determined that no papillary muscle was present, 17 estimates provided poor results, and nine estimates were made by the computer when the observer concluded that no papillary muscle was present.