Volumetric Identification of Left Atrial Fibrosis from Delayed Enhancement Magnetic Resonance Imaging in Atrial Fibrillation: Preliminary Results

Delayed gadolinium enhancement magnetic resonance (DE-MR) imaging can be used for in vivo detection of left atrium (LA) fibrosis and scarring, whose identification is important for atrial fibrillation (AF) treatment. This study presents a new tool for 3D visualization of cardiac LA fibrosis based on DE-MR imaging and its qualitative validation by comparison with electro-anatomic mapping (EAM). Angio-MR (MRA) and DE-MR images were acquired and registered applying an affine transformation. Automatic LA segmentation was obtained from MRA images. Color-coded gray level intensities of DE-MR images were used as texture for the LA 3D surface model. The comparison in 4 patients between our 3D surface model and the 3D EAM confirmed the qualitative correspondence between the low-potential areas and the high-enhanced areas in DE-MR. Preliminary results on volumetric visualization of LA fibrosis based on DE-MR and MRA data processing have shown promising results and simple thresholding of our color-coded map could lead to a fast 3D quantification and localization of LA fibrosis.