A novel technique for the three-dimensional visualisation ofradio-frequency ablation lesions using delayed enhancementmagnetic resonance imaging

摘要

The detection of radio-frequency ablation lesions has been shown to be feasible using delayed enhancement magnetic resonance imaging (MRI). However, it is the determination of the lesion patterns that is of import for correlation with clinical outcome and location of gaps. Visualisation of ablation patterns on two-dimensional (2D) MR images is not intuitive. We present a technique for the three-dimensional (3D) visualisation of ablation patterns by creating a surface from a segmentation of the cardiac chamber of interest, fusing with the delayed enhancement MRI and integrating the MR signal along vectors normal to the cardiac surface. Areas of delayed enhancement will have a larger integral value than healthy myocardium. Maximum intensity projection (MIP) values were used to colour code the cardiac surface for 3D visualisation of the areas of delayed enhancement. The technique was applied to three patients with a cardiac arrhythmia, with successful visualisation of the ablation pattern. Patterns of delayed enhancement were correlated with ablation points derived from electro-anatomical mapping systems (EAMS) and were found to have similar patterns. This visualisation technique allows for the intuitive visualisation of ablation lesions and has many applications for use in electrophysiology.