Using cine MR images to evaluate myocardial infarct transmurality on delayed enhancement images

Evaluating myocardial viability is an important prognostic factor in the follow-up of infarctions. Delayed enhancement (DE) perfusion images in MRI have been shown to be very valuable in the evaluation of myocardial viability. Visual interpretation is the most commonly used method. This study aims to segment the (DE) images prior to the estimation of the extent of infarcted tissue. Segmenting the myocardium using cine contraction images presents a high contrast between cavity and myocardium. After the segmentation, the fuzzy c-mean clustering algorithm was applied to estimate segmental transmurality using a conventional five point scale, which was then compared to the visual classification provided by the experts. Results on 14 patients (224 segments) showed an absolute agreement of 81% and a relative agreement (with one point difference) of 93%.