Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Stroke. 2010 Apr;41(4):691-4. doi: 10.1161/STROKEAHA.109.566430. Epub 2010 Feb 24.
Intracerebral hemorrhage volume (ICHV) as a percentage of total brain volume (TBV) is a strong predictor of outcome in childhood intracerebral hemorrhage with ICHV/TBV >2% associated with functional impairment. We aimed to determine whether easily performed approximations of intracerebral hemorrhage and brain volume can accurately and reliably stratify intracerebral hemorrhage by size.
CT scans of 18 children with spontaneous intracerebral hemorrhage were independently reviewed by 4 neurologists. ICHV as a proportion of TBV was estimated as ABC/XYZ expressed as a percentage: A= largest axial hemorrhage diameter; B=largest axial diameter perpendicular to A on the same slice; and C=hemorrhage vertical diameter. Similarly, X=largest midline axial diameter of supratentorial brain; Y=largest axial diameter perpendicular to X; and Z=brain vertical diameter. Interrater reliability was measured with intraclass correlation coefficients. ICHV and TBV were measured using computer-assisted manual segmentation tracings to establish criterion validity. Each intracerebral hemorrhage was classified as small (< or = 2% TBV) or large (>2% TBV).
Estimates of ICHV, TBV, and ICHV/TBV using the ABC/XYZ method had outstanding interrater reliability (intraclass correlation coefficient, 0.95 to 0.99). These estimates were highly correlated with volumetric measures (R2=0.77 to 0.96). Sensitivity of the ABC/XYZ method for identifying an ICHV >2% TBV was 100% (95% CI, 89% to 100%). Specificity was 95% (95% CI, 83% to 99%).
The ABC/XYZ method accurately and reliably estimates ICHV and TBV in children. These values can be used to approximate quickly and easily ICHV as a percentage of TBV, which has important prognostic implications.
颅内血肿量（ICHV）占总脑容量（TBV）的百分比是儿童颅内血肿预后的一个强有力的预测指标，ICHV/TBV＞2％与功能障碍相关。我们旨在确定是否可以通过大小对颅内血肿进行准确可靠的分层。
18 例自发性颅内出血患儿的 CT 扫描由 4 位神经科医生独立进行了复查。ICHV 与 TBV 的比例作为 ABC/XYZ 表示，以百分比表示：A=最大轴向血肿直径；B=同一切片上与 A 垂直的最大轴向直径；C=血肿垂直直径。同样，X=幕上大脑最大中线轴向直径；Y=与 X 垂直的最大轴向直径；Z=大脑垂直直径。使用组内相关系数测量组内可靠性。使用计算机辅助手动分割轨迹测量 ICHV 和 TBV，以建立标准效度。将每个颅内血肿分为小（≤2％TBV）或大（＞2％TBV）。
使用 ABC/XYZ 方法估计的 ICHV、TBV 和 ICHV/TBV 的组内可靠性极高（组内相关系数，0.95 至 0.99）。这些估计与容积测量高度相关（R2=0.77 至 0.96）。ABC/XYZ 方法识别 ICHV＞2％TBV 的敏感性为 100％（95％CI，89％至 100％）。特异性为 95％（95％CI，83％至 99％）。
ABC/XYZ 方法可准确可靠地评估儿童的 ICHV 和 TBV。这些值可用于快速简便地估算 ICHV 占 TBV 的百分比，这具有重要的预后意义。
