Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study

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dc.contributor.authorNtsekhe, Mpikoen_ZA
dc.contributor.authorMayosi, Bonganien_ZA
dc.contributor.authorGumbo, Tawandaen_ZA
dc.date.accessioned2015-10-30T09:34:34Z
dc.date.available2015-10-30T09:34:34Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND:The purpose of this study was to quantify the heterogeneous distribution of echodensities in the pericardial fluid of patients with tuberculous pericarditis using echocardiography and fractal analysis, and to determine whether there were differences in the fractal dimensions of effusive-constrictive and effusive non-constrictive disease. METHODS: We used fractal geometry to quantify the echocardiographic densities in patients who were enrolled in the Investigation of the Management of Pericarditis in Africa (IMPI Africa) Registry. Sub-costal and four chamber images were included in the analysis if a minimum of two clearly identified fibrin strands were present and the quality of the images were of a standard which allowed for accurate measurement of the fractal dimension. The fractal dimension was calculated as follows: Df=limlog N(s)/[log (l/s)], where Df is the box counting fractal dimension of the fibrin strand, s is the side length of the box and N(s) is the smallest number of boxes of side length s to cover the outline of the object being measured. We compared the fractal dimension of echocardiographic findings in patients with effusive constrictive pericarditis to effusive non-constrictive pericardial effusion using the non-parametric Mann-Whitney test. RESULTS: Of the 14 echocardiographs from 14 participants that were selected for the study, 42.8% (6/14) of images were subcostal views while 57.1% (8/14) were 4-chamber views. Eight of the patients had tuberculous effusive constrictive pericarditis while 6 had tuberculous effusive non-constrictive pericarditis. The mean fractal dimension Df was 1.325 with a standard deviation (SD) of 0.146. The measured fibrin strand dimension exceeded the topological dimension in all the images over the entire range of grid scales with a correlation coefficient (r2) greater than 0.8 in the majority. The fractal dimension of echodensities was 1.359+/-0.199 in effusive constrictive pericarditis compared to 1.330+/-0.166 in effusive non-constrictive pericarditis (p=0.595). CONCLUSIONS: The echocardiographic densities in tuberculous pericardial effusion have a fractal geometrical dimension which is similar in pure effusive and effusive constrictive disease.en_ZA
dc.identifier.apacitationNtsekhe, M., Mayosi, B., & Gumbo, T. (2012). Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study. <i>Cardiovascular Ultrasound</i>, http://hdl.handle.net/11427/14531en_ZA
dc.identifier.chicagocitationNtsekhe, Mpiko, Bongani Mayosi, and Tawanda Gumbo "Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study." <i>Cardiovascular Ultrasound</i> (2012) http://hdl.handle.net/11427/14531en_ZA
dc.identifier.citationNtsekhe, M., Mayosi, B. M., & Gumbo, T. (2012). Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study. Cardiovascular ultrasound, 10(1), 1-6.en_ZA
dc.identifier.ris TY - Journal Article AU - Ntsekhe, Mpiko AU - Mayosi, Bongani AU - Gumbo, Tawanda AB - BACKGROUND:The purpose of this study was to quantify the heterogeneous distribution of echodensities in the pericardial fluid of patients with tuberculous pericarditis using echocardiography and fractal analysis, and to determine whether there were differences in the fractal dimensions of effusive-constrictive and effusive non-constrictive disease. METHODS: We used fractal geometry to quantify the echocardiographic densities in patients who were enrolled in the Investigation of the Management of Pericarditis in Africa (IMPI Africa) Registry. Sub-costal and four chamber images were included in the analysis if a minimum of two clearly identified fibrin strands were present and the quality of the images were of a standard which allowed for accurate measurement of the fractal dimension. The fractal dimension was calculated as follows: Df=limlog N(s)/[log (l/s)], where Df is the box counting fractal dimension of the fibrin strand, s is the side length of the box and N(s) is the smallest number of boxes of side length s to cover the outline of the object being measured. We compared the fractal dimension of echocardiographic findings in patients with effusive constrictive pericarditis to effusive non-constrictive pericardial effusion using the non-parametric Mann-Whitney test. RESULTS: Of the 14 echocardiographs from 14 participants that were selected for the study, 42.8% (6/14) of images were subcostal views while 57.1% (8/14) were 4-chamber views. Eight of the patients had tuberculous effusive constrictive pericarditis while 6 had tuberculous effusive non-constrictive pericarditis. The mean fractal dimension Df was 1.325 with a standard deviation (SD) of 0.146. The measured fibrin strand dimension exceeded the topological dimension in all the images over the entire range of grid scales with a correlation coefficient (r2) greater than 0.8 in the majority. The fractal dimension of echodensities was 1.359+/-0.199 in effusive constrictive pericarditis compared to 1.330+/-0.166 in effusive non-constrictive pericarditis (p=0.595). CONCLUSIONS: The echocardiographic densities in tuberculous pericardial effusion have a fractal geometrical dimension which is similar in pure effusive and effusive constrictive disease. DA - 2012 DB - OpenUCT DO - 10.1186/1476-7120-10-30 DP - University of Cape Town J1 - Cardiovascular Ultrasound LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study TI - Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study UR - http://hdl.handle.net/11427/14531 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14531
dc.identifier.urihttp://dx.doi.org/10.1186/1476-7120-10-30
dc.identifier.vancouvercitationNtsekhe M, Mayosi B, Gumbo T. Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study. Cardiovascular Ultrasound. 2012; http://hdl.handle.net/11427/14531.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2012 Ntsekhe et al.; licensee BioMed Central Ltden_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceCardiovascular Ultrasounden_ZA
dc.source.urihttp://www.cardiovascularultrasound.com/en_ZA
dc.subject.otherPericardial effusionen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherFractal dimensionen_ZA
dc.subject.otherEffusive constrictive pericarditisen_ZA
dc.subject.otherEffusive non-constrictive pericarditisen_ZA
dc.titleQuantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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