Purpose

Decision support systems for mitral valve disease are an important step toward personalized surgery planning. A simulation of the mitral valve apparatus is required for decision support. Building a model of the chordae tendineae is an essential component of a mitral valve simulation. Due to image quality and artifacts, the chordae tendineae cannot be reliably detected in medical imaging.

Methods

Using the position-based dynamics framework, we are able to realistically simulate the opening and closing of the mitral valve. Here, we present a heuristic method for building an initial chordae model needed for a successful simulation. In addition to the heuristic, we present an interactive editor to refine the chordae model and to further improve pathology reproduction as well as geometric approximation of the closed valve.

Results

For evaluation, five mitral valves were reconstructed based on image sequences of patients scheduled for mitral valve surgery. We evaluated the approximation of the closed valves using either just the heuristic chordae model or a manually refined model. Using the manually refined models, prolapse was correctly reproduced in four of the five cases compared to two of the five cases when using the heuristic. In addition, using the editor improved the approximation in four cases.

Conclusions

Our approach is suitable to create realistically parameterized mitral valve apparatus reconstructions for the simulation of normally and abnormally closing valves in a decision support system.

中文翻译：

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交互式编辑腱索虚拟腱索，以模拟决策支持系统中的二尖瓣

目的

二尖瓣疾病的决策支持系统是朝着个性化手术计划迈出的重要一步。为了决策支持，需要对二尖瓣装置进行仿真。建立腱腱索的模型是二尖瓣模拟的重要组成部分。由于图像质量和伪影，在医学成像中无法可靠地检测到腱索。

方法

使用基于位置的动力学框架，我们能够现实地模拟二尖瓣的打开和关闭。在这里，我们提出一种启发式方法，用于建立成功进行仿真所需的初始弦线模型。除了启发式方法外，我们还提供了一个交互式编辑器，以改进弦线模型并进一步改善病理学再现以及闭合瓣的几何近似。

结果

为了进行评估，根据计划进行二尖瓣手术的患者的图像序列重建了五个二尖瓣。我们仅使用试探性腱索模型或手动精炼模型评估了关闭阀的近似值。使用手动改进的模型，与使用启发式方法的五种情况中的两种相比，五种情况中的四种可以正确地再现脱垂。另外，使用编辑器在四种情况下改善了近似值。

结论

我们的方法适合于创建现实参数化的二尖瓣装置重建，以模拟决策支持系统中的正常和异常关闭阀。