At this stage you must review the end-diastolic epicardial borders within four of the short-axis images. VentricularTools will generate an automatic delineation, but you must check their accuracy and correct the lines if necessary.
If a section of the delineation is inaccurate, click and drag along the correct epicardial border as shown in the illustration below.
If the whole delineation is inaccurate, click and drag around the entire epicardial border to draw a new contour.
It is important that you delineate the outflow tract of the left ventricle in a consistent manner. In each basal short axis image, you should decide whether the outflow tract is shown as a separate region to the inflow tract. If they are separate, you should only draw a contour around the inflow tract. If they are joined, you should draw a contour around both. In order to perform a comprehensive analysis, the software requires you to draw contours that extend into the left atrium as shown below.
Once you have corrected the contours in all of the four images, click on the next stage of the workflow. You will need to repeat this step until all epicardial borders for both end-diastole and end-systole are accurately delineated.
Step 5 - Reviewing the epicardial contours