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Related Experiment Video

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Quantification of left ventricular trabeculae using fractal analysis.

Gabriella Captur1, Vivek Muthurangu, Christopher Cook

  • 1Division of Cardiovascular Imaging, The Heart Hospital, part of University College London NHS Foundation Trust, 16-18 Westmoreland Street, London, W1G 8PH, UK.

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
|May 14, 2013
PubMed
Summary

Fractal dimension analysis of cardiac magnetic resonance imaging offers a novel, accurate method for diagnosing left ventricular noncompaction (LVNC). This technique quantifies myocardial trabeculation, improving upon existing criteria for this cardiac disorder.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Left ventricular noncompaction (LVNC) is a myocardial disorder characterized by excessive left ventricular (LV) trabeculae.
  • Current quantification methods for LV trabeculae have limitations.
  • Trabeculae exhibit complex and irregular patterns, suggesting a role for fractal geometry in their analysis.

Purpose of the Study:

  • To introduce a novel technique for quantifying LV trabeculation using cardiovascular magnetic resonance (CMR) and fractal geometry.
  • To determine if measuring the fractal dimension (FD) of the endocardial border can quantitatively distinguish normal from abnormal trabecular patterns.
  • To assess the accuracy and reproducibility of this novel fractal analysis method.

Main Methods:

  • Fractal analysis, specifically the box-counting method, was employed on CMR short-axis cine stacks to measure LV FD.
  • Three groups were studied: LVNC patients (n=30), healthy white volunteers (n=75), and healthy black volunteers (n=30).
  • FD was measured to quantify the complexity and space-filling properties of LV trabeculae.

Main Results:

  • A characteristic pattern of FD variation from base to apex was observed in healthy volunteers, which was altered in LVNC patients with abnormally elevated apical FD.
  • Healthy black volunteers exhibited higher apical FD than healthy white volunteers.
  • The fractal method demonstrated higher accuracy and reproducibility (ICC, 0.97 and 0.96) compared to established CMR criteria (Petersen and Jacquier) for LVNC diagnosis.

Conclusions:

  • Fractal dimension is significantly higher in LVNC patients than in healthy individuals, and also higher in healthy black individuals compared to whites.
  • Fractal analysis provides a reproducible and accurate quantitative measure of trabeculation for LVNC diagnosis.
  • This novel fractal geometry approach offers a superior alternative to current CMR criteria for diagnosing LVNC.