Cardiovascular magnetic resonance (CMR) derived fractal analysis of the left ventricle (LV) has been shown in adults to be a useful quantitative measure of trabeculation with high reproducibility and accuracy for the diagnosis of LV non-compaction (LVNC). The aim of this study was to investigate the utility and feasibility of fractal analysis in children. Eighty-four subjects underwent CMR: (1) 28 patients with LVNC (as defined by the Petersen criteria with NC/C ratio $$\ge$$ 2.3); (2) 28 patients referred by clinicians for assessment of hyper-trabeculation and found not to qualify as LVNC (NC/C $$\ge$$ 1.8 and < 2.3); (3) 28 controls. The fractal scores for each group were presented as global and maximal fractal dimension as well as for 3 segments of the LV: basal, mid, and apical. Statistical comparison of the fractal scores between the 3 groups was performed. Global fractal dimension (FD) was higher in the LVNC group than in the hyper-trabeculated group: 1.345 (SEM 0.053) vs 1.252 (SEM 0.034), p < 0.001 and higher in hyper-trabeculated group than in controls: 1.252 (SEM 0.034) vs 1.158 (SEM 0.038), p < 0.001. The highest maximum FD was in the apical portion of the LV in the LVNC group, (1.467; SEM 0.035) whereas it was in the mid ventricle in the hyper-trabeculated (1.327; SEM 0.025) and healthy groups (1.251; SEM 0.042). Fractal analysis showed lower intra- and interobserver variability than the Petersen and Jacquier methods. It is technically feasible to perform fractal analysis in children using CMR and that it is quick, accurate and reproducible. Fractal scoring accurately distinguishes between LVNC, hyper-trabeculation and healthy controls as defined by the Petersen criteria.

中文翻译：

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儿童左心室致密化不全：心血管磁共振衍生的分形分析可以帮助诊断吗？


心血管磁共振 (CMR) 衍生的左心室 (LV) 分形分析在成人中已被证明是一种有用的小梁形成定量测量方法，具有高重复性和准确性，可用于诊断 LV 致密化不全 (LVNC)。本研究的目的是探讨分形分析在儿童中的实用性和可行性。 84 名受试者接受了 CMR：(1) 28 名 LVNC 患者（根据 Petersen 标准定义，NC/C 比率 $$\ge$$ 2.3）； (2) 28 名患者经临床医生转介进行过度小梁形成评估，但发现不符合 LVNC 资格（NC/C $$\ge$$ 1.8 且 < 2.3）； (3) 28 个控件。每组的分形得分以整体和最大分形维数以及 LV 的 3 个部分（基底、中部和顶端）的形式呈现。对3组之间的分形得分进行统计比较。 LVNC 组的总体分形维数 (FD) 高于超小梁组：1.345 (SEM 0.053) vs 1.252 (SEM 0.034)，p < 0.001，超小梁组的总体分形维数 (FD) 高于对照组：1.252 (SEM 0.034) ) 对比 1.158 (SEM 0.038)，p < 0.001。 LVNC 组中最大 FD 位于左室心尖部分（1.467；SEM 0.035），而超小梁组（1.327；SEM 0.025）和健康组（1.251；SEM 0.042）则位于心室中部。 。分形分析显示观察者内和观察者间的变异性低于 Petersen 和 Jacquier 方法。使用 CMR 对儿童进行分形分析在技术上是可行的，并且快速、准确且可重复。分形评分可准确区分 LVNC、超小梁和 Petersen 标准定义的健康对照。