Method for image processing and contour assessment of the heart

• US 7,693,563 B2
• Filed: 01/30/2004
• Issued: 04/06/2010
• Est. Priority Date: 01/30/2003
• Status: Expired due to Fees

• Current Assignee: Chase Medical LP
• Original Assignee: The Chase Manhattan Bank (JP Morgan Chase & Co)
• Inventors: Dalton, Jude, Suresh, Mitta
• Primary Examiner(s): Casler; Brian
• Assistant Examiner(s): CWERN, JONATHAN
• Application Number:
  US10/769,745
• Publication Number:
  US 20040153128A1
• Time in Patent Office: 2,258 Days
• Field of Search: 600/439, 600/450, 600/416, 600/509, 600/508, 600/529, 600/407, 382/128, 128/661, 364/413.03
• US Class Current: 600/407
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• CPC Class Codes: G06T 2207/10088 Magnetic resonance imaging [MRI]
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06T 7/12 Edge-based segmentation
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• 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 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

One embodiment discloses a computerized method of facilitating cardiac intervention. The method may include inputting patient data and creating a computerized interactive model of a heart based on the patient data. The model may include features. The model may simulate at least one proposed cardiac intervention by adding or deleting features to the model, and determining the effects of the proposed cardiac simulation upon the entire model. Simulations may be repeated to allow the user to determine an optimal cardiac intervention. A template and/or patient specific instrument may be created from the model to use as a guide during the cardiac intervention.

Claims

1. A method of assessing a state of human heart tissue, comprising:

providing to a computer system a plurality of images of heart tissue, wherein at least one of the images comprises the heart in a substantially expanded condition, and wherein at least one of the images comprises the heart in a substantially contracted condition;

creating a model of at least a portion of a wall of a left ventricle of the heart using the computer system, wherein the model comprises the left ventricle in at least an end-systolic state and an end-diastolic state;

assessing a movement of one or more parts of the wall model between the end-systolic state and the end-diastolic state;

assessing a transmurality of one or more parts of the wall model;

comparing the movement to the transmurality to assess a ratio of recoverable heart tissue verses nonrecoverable heart tissue; and

comparing the ratio to a predetermined number to assess a state of the heart and an optimal treatment of the heart.

2. The method of claim 1, wherein the predetermined number comprises an average of a plurality of normal hearts.

3. The method of claim 1, further comprising displaying the state of the heart visually within the model.

4. The method of claim 1, further comprising displaying the state of the heart visually within the model using a color gradient.

5. The method of claim 1, further comprising matching at least one part of the wall of the model in the end-systolic state with a corresponding part of the wall of the model in the end-diastolic state.

6. The method of claim 1, further comprising matching at least one part of the wall of the model in the end-systolic state with a corresponding part of the wall of the model in the end-diastolic state using one or more normals associated with the parts.

7. The method of claim 1, further comprising determining a number of parts in which the movement of each part is greater than a range from the predetermined number.

8. The method of claim 1, further comprising:

determining a number of parts in which the movement of each part is greater than a range from the predetermined number; and

dividing the number of parts by a total number of parts.

9. The method of claim 1, wherein the assessed movement comprises movement towards a centerline of the heart.

10. The method of claim 1, wherein the assessed movement comprises wall thickness variation.

11. The method of claim 1, wherein at least one part with assessed movement comprises a point in the wall.

12. The method of claim 1, wherein at least one part with assessed movement comprises a plurality of points in the wall.

13. The method of claim 1, further comprising displaying the state of the heart visually with a plurality of colors, wherein the colors represent kinetic properties of at least one part.

14. The method of claim 1, further comprising displaying the state of the heart visually with a plurality of colors, wherein each of the colors represent different kinetic properties.

15. The method of claim 1, further comprising assessing kinetics of at least a portion of the heart tissue.

16. The method of claim 15, further comprising identifying hyper-kinetic tissue from the assessed kinetics.

17. The method of claim 15, further comprising identifying hyper-kinetic tissue from the assessed kinetics, wherein hyper-kinetic tissue comprises tissue with movement of two or more standard deviations greater than the predetermined number.

18. The method of claim 15, further comprising identifying akinetic tissue from the assessed kinetics, wherein akinetic tissue comprises tissue with movement of two or more standard deviations less than the predetermined number.

19. The method of claim 15, further comprising identifying normal tissue from the assessed kinetics.

20. The method of claim 15, further comprising identifying normal tissue from the assessed kinetics, wherein normal tissue comprises tissue with movement that deviates in an amount that is from zero to about two standard deviations from the predetermined number.

21. The method of claim 15, further comprising identifying diskinetic tissue from the assessed kinetics.

22. The method of claim 15, further comprising identifying diskinetic tissue from the assessed kinetics, wherein diskinetic tissue comprises tissue with movement away from a centerline of the heart.

23. The method of claim 15, further comprising identifying akinetic tissue from the assessed kinetics.

24. The method of claim 23, further comprising assessing tissue suitable for revascularization, wherein tissue suitable for revascularization comprises viable, akinetic tissue.

25. The method of claim 23, further comprising assessing tissue suitable for revascularization, wherein tissue suitable for revascularization comprises viable, akinetic tissue with an akinetic area greater than a predetermined akinetic area.

26. The method of claim 23, further comprising assessing tissue suitable for revascularization, wherein tissue suitable for revascularization comprises viable, akinetic tissue with a non-viable area less than a predetermined non-viable area, wherein the non-viable area is assessed from the plurality of images.

27. The method of claim 23, further comprising assessing tissue suitable for revascularization, wherein tissue suitable for revascularization comprises viable, akinetic tissue with an akinetic area greater than a predetermined akinetic area and akinetic tissue with a non-viable area less than a predetermined non-viable area, wherein the non-viable area is assessed from the plurality of images.

28. The method of claim 1, wherein the model comprises a three-dimensional model.

29. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises at least a predetermined amount of non-viable tissue area, and wherein the non-viable tissue area is assessed from the plurality of images.

30. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises at least a predetermined amount of non-viable tissue volume, and wherein the non-viable tissue volume is assessed from the plurality of images.

31. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises at least a predetermined amount of non-viable tissue mass, and wherein the non-viable tissue mass is assessed from the plurality of images.

32. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises at least a predetermined amount of non-viable tissue and at least a predetermined amount of akinetic tissue.

33. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises at least a predetermined amount of non-viable tissue and at least a predetermined end diastolic volume.

34. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises at least a predetermined amount of non-viable tissue and at least a predetermined transmurality.

35. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises an ejection fraction less than a predetermined ejection fraction.

36. The method of claim 1, further comprising assessing if a heart is a potential candidate for ventricular reconstruction, wherein the heart is a potential candidate for ventricular reconstruction if the heart comprises an ejection fraction less than about 35%.

37. The method of claim 1, further comprising assessing if a heart is a potential candidate for mitral valve repair, wherein the heart is a potential candidate for mitral valve repair if the heart comprises at least a selected papillary muscle distance, at least a selected papillary muscle angle, and at least a selected amount of mitral regurgitation.

38. The method of claim 1, further comprising assessing if a heart is a potential candidate for mitral valve repair, wherein the heart is a potential candidate for mitral valve repair if the heart comprises at least a selected papillary muscle distance.

39. The method of claim 1, further comprising assessing if a heart is a potential candidate for mitral valve repair, wherein the heart is a potential candidate for mitral valve repair if the heart comprises at least a selected papillary muscle angle.

40. The method of claim 1, further comprising assessing if a heart is a potential candidate for mitral valve repair, wherein the heart is a potential candidate for mitral valve repair if the heart comprises at least a selected amount of mitral regurgitation.