Mitral valve flattening and parameter mapping for patient-specific valve diagnosis

PURPOSE: Intensive planning and analysis from echocardiography are a crucial step before reconstructive surgeries are applied to malfunctioning mitral valves. Volume visualizations of echocardiographic data are often used in clinical routine. However, they lack a clear visualization of the crucial factors for decision making. METHODS: We build upon patient-specific mitral valve surface models segmented from echocardiography that represent the valve’s geometry, but suffer from self-occlusions due to complex 3D shape. We transfer these to 2D maps by unfolding their geometry, resulting in a novel 2D representation that maintains anatomical resemblance to the 3D geometry. It can be visualized together with color mappings and presented to physicians to diagnose the pathology in one gaze without the need for further scene interaction. Furthermore, it facilitates the computation of a Pathology Score, which can be used for diagnosis support. RESULTS: Quality and effectiveness of the proposed methods were evaluated through a user survey conducted with domain experts. We assessed pathology detection accuracy using 3D valve models in comparison with the novel visualizations. Classification accuracy increased by 5.3% across all tested valves and by 10.0% for prolapsed valves. Further, the participants’ understanding of the relation between 3D and 2D views was evaluated. The Pathology Score is found to have potential to support discriminating pathologic valves from normal valves. CONCLUSIONS: In summary, our survey shows that pathology detection can be improved in comparison with simple 3D surface visualizations of the mitral valve. The correspondence between the 2D and 3D representations is comprehensible, and color-coded pathophysiological magnitudes further support the clinical assessment.