arXiv:2502.09805eess.IVcs.CV2025-02被引 5

自动分割4D CT中的主动脉瓣,助力个性化手术规划。

Towards Patient-Specific Surgical Planning for Bicuspid Aortic Valve Repair: Fully Automated Segmentation of the Aortic Valve in 4D CT

  • 基于nnU-Net构建全自动多标签分割流程。
  • 分割精度达Dice>0.7,平均对称距离<0.7mm。
  • 结果可支持手术风险评估,适合临床应用。

二尖瓣主动脉瓣(BAV)是最常见的先天性心脏病,可能因狭窄、反流或主动脉病变需手术治疗。由于BAV形态多样,修复手术难度大。增强型4D CT可提供高对比度和空间分辨率的时序体积图像,有助于定量评估BAV以指导手术规划。准确分割主动脉瓣叶和根部是构建个性化模型的关键步骤。尽管深度学习方法可实现全自动分割,但尚无针对BAV的专用模型。现有研究对分割结果的临床可用性评估有限。本文提出一种基于nnU-Net的全自动多标签BAV分割流程,用于计算几何瓣叶高度、交界角和瓣环直径等术前相关测量,并与人工分割结果对比。自动化分割在所有三个瓣叶及根壁上的平均Dice分数超过0.7,对称均方距离低于0.7 mm。临床相关指标显示预测结果与人工标注高度一致。总体而言,4D CT中3D帧的全自动BAV分割可生成可用于手术风险分层的临床可用测量数据,但分割结果的时间一致性仍需改进。

原文摘要 · Abstract (English)

The bicuspid aortic valve (BAV) is the most prevalent congenital heart defect and may require surgery for complications such as stenosis, regurgitation, and aortopathy. BAV repair surgery is effective but challenging due to the heterogeneity of BAV morphology. Multiple imaging modalities can be employed to assist the quantitative assessment of BAVs for surgical planning. Contrast-enhanced 4D computed tomography (CT) produces volumetric temporal sequences with excellent contrast and spatial resolution. Segmentation of the aortic cusps and root in these images is an essential step in creating patient specific models for visualization and quantification. While deep learning-based methods are capable of fully automated segmentation, no BAV-specific model exists. Among valve segmentation studies, there has been limited quantitative assessment of the clinical usability of the segmentation results. In this work, we developed a fully automated multi-label BAV segmentation pipeline based on nnU-Net. The predicted segmentations were used to carry out surgically relevant morphological measurements including geometric cusp height, commissural angle and annulus diameter, and the results were compared against manual segmentation. Automated segmentation achieved average Dice scores of over 0.7 and symmetric mean distance below 0.7 mm for all three aortic cusps and the root wall. Clinically relevant benchmarks showed good consistency between manual and predicted segmentations. Overall, fully automated BAV segmentation of 3D frames in 4D CT can produce clinically usable measurements for surgical risk stratification, but the temporal consistency of segmentations needs to be improved.

主动脉瓣4D CT分割手术规划

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