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Background Left ventricular (LV) fractal dimension (FD) on cardiac magnetic resonance (CMR) balanced steady-state free precession (SSFP) cines has already proven to be useful in making a diagnosis of non-compaction cardiomyopathy. Normal FD values for SSFP cines have been established (Captur 2015). Fast gradient echo (fGRE) sequences have different contrast between blood pool and myocardium, which affects measurement of FD. However, if FD could be measured on fGRE it would allow for retrospective analysis of scans acquired before implementation of SSFP or in patients with devices that underwent fGRE. The aim of this study was to establish a correlation between FD measured on SSFP and fGRE sequences in the same subjects. Methods Twelve participants of Barts Cardiovascular Registry who underwent cardiac magnetic resonance (CMR) imaging with 1.5T scanners for various clinical reasons had cine short axis stack (SAX) acquired with both SSFP and fGRE sequences. We measured FD in 57 corresponding (positioned in the same LV location) SAX cine slices on SSFP and fGRE using dedicated MATLAB script and an Osirix “LVFractalAnalysisFilter” plugin written in Objective-C with equivalent architecture. The same region-based level-set segmentation and fractal procedure was implemented. Briefly: the scale parameter specifying the size of the neighbourhood (sigma) was set to 2%; size of the initial contour was set to 6 × 9 pixels; and maximum initial grid-size for fractal analysis was 45% of the original size of the region of interest estimated through the application of a scaled bounding box.

Can left ventricular endocardial surface roughness be measured by fractal dimension on fast gradient echo sequences?