Nearly-automated quantification of mitral annulus and leafet morphology from transesophageal real-time 3D echocardiography

The ability to extract and quantify three-dimensional (3D) morphological parameters of the mitral valve (MV) apparatus from transesophageal 3D echocardiographic (T3DE) imaging constitutes a valuable tool in diagnosis, treatment and follow-up of patients with MV disease. Mitral annulus (MA) and leaflets (ML) quantification is still challenging, and commonly based on intensive user interaction that limits its applicability. We proposed a fast and accurate model-free, nearly-automated method for segmenting and extracting MA and ML morphological parameters, requiring a set of only 8 user-defined points. The algorithm accuracy was tested on 12 patients compared to 'gold standard' manual analysis, resulting in narrow limits of agreement, and good inter- and intra-observer variability, except for MA height computation. The proposed technique appears promising for clinical application.