Automatic Segmentation and Evaluation of Mitral Regurgitation Using Doppler Echocardiographic Images

Mitral Regurgitation (MR) is a common heart valve disease. Severe MR can lead to pulmonary hypertension, cardiac arrhythmia, and even death. Therefore, early diagnosis and assessment of MR severity are crucial. In this study, we propose a deep learning-based method for segmenting MR regions, aiming to improve the efficiency of MR severity classification and diagnosis.

We enhanced the Efficient Multi-Scale Attention (EMA) module to capture multi-scale features more effectively, thereby improving its segmentation performance on MR regions, which vary widely in size. A total of 367 color Doppler echocardiography images were acquired, with 293 images used for model training and 74 images for testing. To fully validate the capability of the improved EMA module, we use ResUNet as the backbone, partially integrating the enhanced EMA module into the decoder's upsampling process. The proposed model is then compared with classic models like Deeplabv3+ and PSPNet, as well as UNet, ResUNet, ResUNet with the original EMA module added, and UNet with the improved EMA module added.

The experimental results demonstrate that the model proposed in this study achieved the best performance for the segmentation of the MR region on the test dataset: Jaccard (84.37%), MPA (92.39%), Recall (90.91%), and Precision (91.9%). In addition, the classification of MR severity based on the segmentation mask generated by our proposed model also achieved acceptable performance: Accuracy (95.27%), Precision (88.52%), Recall (91.13%), and F1-score (90.30%).

The model proposed in this study achieved accurate segmentation of MR regions, and based on its segmentation mask, automatic and accurate assessment of MR severity can be realized, potentially assisting radiologists and cardiologists in making decisions about MR.