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Chagas disease is a disease of major clinical relevance, with high incidence. The relation between the myocardial tissue damage, myocardial perfusion and defects in the autonomic innervations is poorly understood. This work proposes the development and application of image analysis methods capable of providing an integrated visualization and analysis of tissue injuries through magnetic resonance imaging (MRI), autonomic innervations and myocardial perfusion, available through photon emission tomography (SPECT). This paper describes and evaluates a method for tissue characterization and quantification. The proposed method is based on segmentation of MRI and registration between MRI images and SPECT images using MIBG and 99Tc (m)MIBI. To perform the segmentation of myocardium, we used Geodesic Active Contour. Fibrosis segmentation in MRI images was performed based on the algorithm of maximum Tsallis entropy. Nonrigid registration was performed based on B-Spline method. Initially, the registration was made between SPECT images using 99Tc (m)-MIBI and MIBG. Then MRI volumes were registered with SPECT images. It is possible to observe regions of fibrosis and with absence or low synaptic activity comparatively to myocardial perfusion. The relationship of regions of fibrosis and regions with absence of synaptic activity was obtained by Spearman correlation, which provided a correlation coefficient of 0.9371. Thus, the developed tool provides an integrated analysis of information contributing to a better understanding of the relationship between myocardial tissue damage and autonomic innervations injuries caused by Chagas disease.

Métodos de análise de imagens aplicados à caracterização tecidual, perfusão miocárdica e inervação autonômica em MRI e SPECT no contexto da doença de Chagas