Rapid quantitative evaluations of heart function with strain measurements from MRI

• US 10,524,687 B2
• Filed: 04/26/2017
• Issued: 01/07/2020
• Est. Priority Date: 04/27/2016
• Status: Active Grant

• Current Assignee: Myocardial Solutions, Inc.
• Original Assignee: Myocardial Solutions, Inc.
• Inventors: Osman, Nael F.
• Primary Examiner(s): Eastwood, David C
• Assistant Examiner(s): Asghar, Aminah
• Application Number:
  US15/498,058
• Publication Number:
  US 20170311839A1
• Time in Patent Office: 986 Days
• CPC Class Codes: A61B 2576/023 for the heart
• CPC Class Codes: A61B 5/0037 Performing a preliminary scan, e.g. a prescan for identifying a region of interest
• CPC Class Codes: A61B 5/0044 for the heart
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts
• CPC Class Codes: A61B 5/7292 Prospective gating, i.e. predicting the occurrence of a physiological event for use as a synchronisation signal
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Rapid quantitative evaluations of heart function are carried out with strain measurements from Magnetic Resonance Imaging (MRI) images using a circuit at least partially onboard or in communication with an MRI Scanner and in communication with the at least one display, the circuit including at least one processor that: obtains a plurality of series of MRI images of long and short axis planes of a heart of a patient, with each series of the MRI images is taken over a different single beat of the heart of the patient during an image session that is five minutes or less of active scan time and with the patient in a bore of the MRI Scanner; measures strain of myocardial heart tissue of the heart of the patient based on the plurality of series of MRI images of the heart of the patient; and generates longitudinal and circumferential heart models with a plurality of adjacent compartments, wherein the compartments are color-coded based on the measured strain.

Claims

1. A medical workstation, comprising:

at least one display; and

a circuit at least partially onboard or in communication with an MRI Scanner and in communication with the at least one display, the circuit comprising at least one processor configured to;

obtain a plurality of series of MRI images of long and short axis planes of a heart of a patient, wherein each series of the plurality of series of MRI images is taken over a different single beat of the heart of the patient during an image session associated with a time period for obtaining the plurality of series of MRI images of the long and short axis planes that is five minutes or less of active scan time and with the patient in a bore of the MRI Scanner;

measure strain of myocardial heart tissue of the heart of the patient based on the plurality of series of MRI images of the heart of the patient;

generate longitudinal and circumferential heart models with a plurality of adjacent compartments, wherein the compartments are color-coded based on the measured strain;

obtain a first preliminary series of MRI images of the heart, prior to obtaining the plurality of series of MRI images of long and short axis planes, from transverse, sagittal and coronal planes to generate a pseudo two chamber view of the heart to determine orientation of the heart of the patient in the bore of the MRI Scanner;

identify a pseudo two-chamber plane or a pseudo four-chamber plane from the obtained first preliminary series of MRI images;

obtain a second preliminary series of MRI images, prior to obtaining the plurality of series of MRI images of long and short axis planes, from the pseudo two-chamber plane or the pseudo four-chamber plane over a single heartbeat;

generate a pseudo two-chamber strain encoded movie from the second preliminary series of MRI images of the pseudo two-chamber plane or generate a pseudo four-chamber strain encoded movie from the second preliminary series of MRI images of the pseudo four-chamber plane;

then

identify a pseudo four-chamber plane from the pseudo two chamber strain encoded movie or identify a pseudo two-chamber plane from the pseudo four chamber strain encoded movie;

identify three short axis imaging planes from the pseudo two chamber strain encoded movie as the three short axis imaging planes for the plurality of series of the MRI images for the strain measurements;

generate short axis basal (SAB), short axis medial (SAM) and short axis apical (SAA) strain encoded movies from the series of MRI images of the three identified short axis imaging planes; and

identify three long axis imaging planes from the pseudo two chamber strain encoded movie as the three long axis imaging planes for the plurality of series of MRI images for the strain measurements.

2. The workstation of claim 1, wherein the strain measurements are color-coded in the longitudinal and circumferential heart models to represent five states of heart muscle contractility:

hyperkinetic, normokinetic, hypokinetic, akinetic and dyskinetic.

3. The workstation of claim 1, wherein the circuit with the at least one processor is further configured to:

search the second preliminary series of MRI images from the pseudo two chamber plane and/or the pseudo two chamber strain encoded movie to identify an MRI image with a time with a maximum total intensity signal to identify a close to end systole segment of a cardiac cycle;

project a line dividing a left ventricle for the identification of the pseudo 4-chamber plane; and

project three lines dividing the left ventricle for the identification of the three short axis planes.

4. The workstation of claim 3, wherein the second preliminary series of MRI images from the pseudo two chamber plane and/or the pseudo two chamber strain encoded movie used to identify the MRI image with the maximum total intensity signal comprise high tuning raw strain encoded MRI images.

5. The workstation of claim 1, wherein the at least one processor is further configured to evaluate dyssynchrony in heart contraction between chambers of the heart and/or in a single heart chamber of the heart of the patient based on a spatial non-uniformity of strain over a cardiac cycle.

6. The workstation of claim 1, wherein the circuit is further configured to calculate a global strain measurement and compare to predefined global values shown to designate normal and abnormal tissue to thereby delineate abnormal tissue as reversible or irreversible.

7. A medical workstation, comprising:

at least one display; and

a circuit at least partially onboard or in communication with an MRI Scanner and in communication with the at least one display, the circuit comprising at least one processor configured to;

obtain a first plurality of series of MRI images of long and short axis planes of a heart of a patient, wherein each series of the first plurality of series of MRI images is taken over a different single beat of the heart of the patient during an image session associated with a time period for obtaining the first plurality of series of MRI images of the long and short axis planes that is five minutes or less of active scan time and with the patient in a bore of the MRI Scanner;

measure strain of myocardial heart tissue of the heart of the patient to generate a first set of strain measurements based on the obtained first plurality of series of MRI images of the heart of the patient;

generate a first set of longitudinal and circumferential heart models with a plurality of adjacent compartments, wherein the compartments are color-coded based on the measured strain;

obtain a second plurality of series of MRI images of long and short axis planes of the heart of the patient after a physical or chemically induced stress challenge, wherein each series of the second plurality of series of the MRI images is taken over a different single heartbeat of the heart of the patient during an image session associated with a time period for obtaining the second plurality of series of MRI images of the long and short axis planes that is five minutes or less of active scan time and with the patient in the bore of the MRI Scanner;

obtain a second set of strain measurements of the myocardial heart tissue of the heart of the patient based on the second plurality of series of MRI images of the heart of the patient; and

generate;

a post-challenge set of the longitudinal and circumferential heart models with the plurality of adjacent compartments, wherein the compartments are color-coded based on the second set of strain measurements from the second plurality of series of MRI images; and

a post-challenge set of the longitudinal and circumferential heart models with the plurality of adjacent compartments, wherein the compartments are color-coded based on a difference between the first and second sets of strain measurements, and

wherein the circuit is configured to cause the at least one display to concurrently display both of the post-challenge sets of the longitudinal and circumferential heart models with the first set of the longitudinal and circumferential heart models.

8. The workstation of claim 7, wherein the at least one processor is further configured to identify dyssynchrony based on a number between 0 to 1, where “

0”

represents full dyssynchrony and “

1”

represents full synchrony, calculated for segments and/or chambers of the heart based on a dispersion of peak shortening over time of the cardiac cycle from the strain measurements obtained at different locations of the heart and different points of time of the cardiac cycle.

9. A medical workstation, comprising:

at least one display; and

a circuit at least partially onboard or in communication with an MRI Scanner and in communication with the at least one display, the circuit comprising at least one processor configured to;

obtain a first plurality of series of MRI images of long and short axis planes of a heart of a patient, wherein each series of the first plurality of series of MRI images is taken over a different single beat of the heart of the patient during an image session associated with a time period for obtaining the first plurality of series of MRI images of the long and short axis planes that is five minutes or less of active scan time and with the patient in a bore of the MRI Scanner;

measure strain of myocardial heart tissue of the heart of the patient to generate a first set of strain measurements based on the first plurality of series of MRI images of the heart of the patient;

generate a first set of longitudinal and circumferential heart models with a plurality of adjacent compartments, wherein the compartments are color-coded based on the measured strain;

obtain a second plurality of series of MRI images of long and short axis planes of the heart of the patient after a physical or chemically induced stress challenge, wherein each series of the second plurality of series of MRI images is taken over a different single heartbeat of the heart of the patient during an image session associated with a time period for obtaining the second plurality of series of MRI images of the long and short axis planes that is five minutes or less of active scan time and with the patient in the bore of a respective MRI Scanner; and

measure strain of myocardial heart tissue of the heart of the patient to generate a second set of strain measurements based on the second plurality of series of MRI images of the heart of the patient; and

generate at least one of;

a post-challenge set of the longitudinal and circumferential heart models with the plurality of adjacent compartments, wherein the compartments are color-coded based on the second set of strain measurements from the second plurality of series of MRI image slices;

or

a post-challenge set of the longitudinal and circumferential heart models with the plurality of adjacent compartments, wherein the compartments are color-coded based on a difference between the first and second sets of strain measurements, and

wherein the physical or chemically induced stress challenge is a low stress challenge corresponding to an increase in heart rate of 10-20 beats per minute.

10. A medical workstation, comprising:

at least one display; and

a circuit at least partially onboard or in communication with an MRI Scanner and in communication with the at least one display, the circuit comprising at least one processor configured to;

obtain a first series of MRI images of a heart of a patient from transverse, sagittal and coronal planes of the heart to determine orientation of the heart of the patient in a bore of the MRI Scanner;

identify a pseudo two-chamber plane or a pseudo four-chamber plane from the obtained first series of MM images;

obtain a second series of MRI images of the heart from the pseudo two-chamber plane or the pseudo four-chamber plane over a single heartbeat;

generate a pseudo two-chamber strain encoded movie of the heart from the second series of MM images of the pseudo two-chamber plane or generate a pseudo four-chamber strain encoded movie of the heart from the second series of MM images of the pseudo four-chamber plane;

then

identify a pseudo four-chamber plane from the pseudo two chamber strain encoded movie or identify a pseudo two-chamber plane from the pseudo four chamber strain encoded movie;

identify three short axis imaging planes from the pseudo two chamber strain encoded movie;

identify three long axis imaging planes from the pseudo two chamber strain encoded movie or the pseudo four chamber strain encoded movie;

obtain a third plurality of series of MRI images from the identified long and short axis planes of the heart;

measure strain of myocardial heart tissue of the heart of the patient based on the obtained third plurality of series of MRI images of the heart; and

generate longitudinal and circumferential heart models with a plurality of adjacent compartments, wherein the compartments are color-coded based on the measured strain,

wherein each series of the third plurality of series of MRI images is taken over a different single heartbeat of the heart of the patient during an image session associated with a time period for obtaining the third plurality of series of MRI images of the long and short axis planes that is five minutes or less of active scan time and with the patient in a bore of the MRI Scanner.

11. The workstation of claim 10, wherein the at least one processor is further configured to:

search the second series of MRI images from the pseudo two chamber plane and/or the pseudo two chamber strain encoded movie to identify an MRI image with a time with a maximum total intensity signal to identify a close to end systole segment of a cardiac cycle; and

project a line dividing a left ventricle of the heart in one or more images from the pseudo two chamber strain encoded movie for the identification of the pseudo 4-chamber plane.

12. The workstation of claim 10, wherein the at least one processor is further configured to generate two chamber, three chamber and four chamber strain encoded movies from the obtained third plurality of series of MRI images.