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Methods Cine-MR images were acquired using a breath-hold ECG-gated steady-state free-precession sequence (TR = 1.54 ms, TE = 1.49 ms, 17 lines per segment, a = 65°, slice thickness = 5 mm, temporal resolution = 27 msec/ images, spatial resolution varied from 0.7 mm to 1.6 mm per pixel, according to the patient examination). The acquisition plane was oriented in aortic valve crosssection. Manual processing on the whole images remains a reliable but time-consuming solution. Then, an automatic method based on mathematical morphology, combining numerical geodesic reconstruction with RANSAC method to estimate area was elaborated in order to segment the aortic root. Relevant points, such as the commissures, the cusps and the centre of the SV are also automatically detected by using a distance transform for centre estimation and a radial study to find extremum radii points. Our method was tested on 13 examinations of patients with SV dilatation (2 women and 11 men, age: 54±11 years, body surface area: 1.97±0.19 m). Considering all images, the maximum distance between two cusps determines the maximum radius. Manual measurement of this parameter was made by an experienced observer. Results There is an excellent correlation between manual and automatic measurements (r= 0.93; y = 0.93 x + 4.0; p<10). The corresponding Bland-Altman study shows an excellent concordance between the two approaches (mean of the differences = 0.5 mm and standard deviation of the differences = 2.3 mm). Figure 1.

Automatic evaluation of the sinus of Valsalva from cine-MRI in patients with dilated aortic root