Ali Z, et al. - In this study, researchers sought to apply fractal analysis to characterize diffusely fibrotic, focally fibrotic, and healthy myocardium in patients with end-stage renal disease (ESRD) on the basis of previously published magnetization transfer (MT) contrast images. This study applied the MT ratio values of individuals with ESRD (n = 34) and healthy control individuals (n = 19) to construct anatomically faithful 3D left ventricular reconstructions. Established MT ratio threshold values were applied to determine healthy, diffusely enhanced, focally enhanced, and total enhanced tissue domains. To reach the domain, the fractal dimension (FD) was estimated using a 3D box-counting algorithm. In individuals with ESRD, the data showed that fatal arrhythmias are increasingly attributed to cardiac fibrosis. It was demonstrated that histologic analysis exhibits that fibrosis progresses via a fractal expansion pattern. The technique shown in this study can be used to identify the irregular space-filling morphometry of any pathologic substrate distinguished by contrast enhancement across noninvasive imaging modalities.