- Poster presentation
- Open Access
Quantitative texture features as objective metrics of enhancement heterogeneity in hypertrophic cardiomyopathy
© Thornhill et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Textural Feature
- Hypertrophic Cardiomyopathy
- Late Gadolinium Enhance
- Segment Group
- SSFP Image
Hypertrophic cardiomyopathy (HCM) results in myocardial disarray, hypertrophy and fibrosis. Late gadolinium enhanced MRI (LGE) can assess the presence and extent of fibrosis, which is associated with the development of arrhythmias and sudden cardiac death. However, enhancement may not always be present or only sparsely distributed. Thus, one of the challenges is how best to describe heterogeneous LGE patterns in an objective fashion that informs clinical decision making. Quantitative texture features may provide clinicians with an objective means of describing the heterogeneity of LGE patterns in HCM. We hypothesized that hypertrophied segments would exhibit greater grey-level heterogeneity than both (a) non-hypertrophied segments in HCM patients, and (b) healthy volunteers.
We prospectively recruited 12 HCM patients and 4 healthy volunteers. Functional (bSSFP cine) and LGE (phase-sensitive inversion recovery spoiled GRE, 10-15 min post injection of 0.2 mmol/kg Gd-DTPA) images were acquired in short-axis orientation (SAO), as well as in one 4-chamber slice. We measured the maximum thickness on the end-diastolic cine frame in the 17 segments (AHA model). Segments measuring > 15 mm on SSFP images were considered hypertrophic (H+). Segments were categorized as fibrotic (F+) if > 20% of pixels were enhanced (> 5 SD nulled myocardium). The extent of myocardial fibrosis on LGE imaging and textural features (run-length non-uniformity, RLNU, and grey-level non-uniformity, GLNU [Galloway 1975]) were assessed for each segment. Differences in RLNU and GLNU among segment groups (H+/F+, H+/F-, H-/F+, H-/F-, and healthy) were assessed by Kruskal-Wallis tests.
Quantitative textural features related to LGE heterogeneity appear elevated in patients with HCM, even in non-hypertrophic segments. In addition, significant statistical differences were found in the textural features between non-hypertrophic, non-fibrotic segments of HCM patients and healthy volunteers. Thus, RLNU and GLNU show potential for markers of incipient cardiomyopathic changes among HCM patients and may provide helpful tools for differentiating diverse phenotypic expressions of the disease from healthy patients, pending further validation.
Nothing to disclose.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.