Etude quantitative du mouvement de la paroi du coeur à partir d'images ciné-IRM par des méthodes fréquentielles de flux optique

Abstract : The aim of this thesis is to study parietal desynchronisation of the left ventricle from conventional cine-MRI. The first part of our work consisted in the quantification of the left ventricle wall motion of the heart directly from conventional retrospective SSFP type cine-MRI sequences used in the study of cardiac function. The developed methods for measuring displacements within the images are frequency-based optical flow methods. These techniques seem to be particularly adapted to MRI specificities. We have demonstrated their robustness in the event of Rician noise and pixel intensity variations as a function of time. These variations are often associated with the through-plane motion of the heart, in particular in the short-axis orientation. The second part of our work concerned the assessment of desynchronisation from short axis cine-MRI. Time-displacement and time-velocity curves of the heart wall were obtained from tracking points of interest localised on the left ventricle segments close to the endocardium. With respect to the quantification of the delay between curves, our work relied on research carried out in the field of echocardiography desynchronisation. Various parameters for the measurement of desynchronisation from cine-MRI were proposed. This work was the subject of a preliminary clinical study including patients considered as normal further based on clinical examination and patients having normal or prolonged QRS duration without ischemic heart disorder. The dyssynchrony measurements from cardiac MRI were compared to measurements obtained with echocardiography. The first results indicate a good correlation between echography and MRI measurements. The third part of our work consisted in studying heart wall motion directly from raw images from multicoil MRI. The developed optical flow algorithms were tested and they showed that it was possible to estimate myocardial movement. Preliminary results are encouraging. The results of the preliminary study of left intraventricular asynchronism from MRI are also promising. Cardiac cine-MRI could be an alternative to echocardiography in the case of weakly echogenic patients. The validation of this quantitative technique for asynchronism from MRI is of major interest. A more detailed study is in progress, in particular to predict the response of CRT (cardiac resynchronisation therapy) of patients without ischemic disorder presenting a mechanical desynchronisation from MRI and echographic parameters.
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Marie Xavier Magnier. Etude quantitative du mouvement de la paroi du coeur à partir d'images ciné-IRM par des méthodes fréquentielles de flux optique. Médecine humaine et pathologie. Université de Bourgogne, 2010. Français. ⟨NNT : 2010DIJOMU02⟩. ⟨tel-00589516⟩

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