STICH II 队列（幕上自发性脑叶出血患者早期手术与初始保守治疗）的半自动化脑出血容量定量回顾性方法分析。
Retrospective Methods Analysis of Semiautomated Intracerebral Hemorrhage Volume Quantification From a Selection of the STICH II Cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas).
机构信息
From the Neurosurgical Trials Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom (M.D.H., B.A.G., A.D.M.); and Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (D.F.H., W.A.M.).
出版信息
Stroke. 2018 Feb;49(2):325-332. doi: 10.1161/STROKEAHA.117.016677. Epub 2018 Jan 10.
BACKGROUND AND PURPOSE
The ABC/2 method for calculating intracerebral hemorrhage (ICH) volume has been well validated. However, the formula, derived from the volume of an ellipse, assumes the shape of ICH is elliptical. We sought to compare the agreement of the ABC/2 formula with other methods through retrospective analysis of a selection of the STICH II cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas).
METHODS
From 390 patients, 739 scans were selected from the STICH II image archive based on the availability of a CT scan compatible with OsiriX DICOM viewer. ICH volumes were calculated by the reference standard semiautomatic segmentation in OsiriX software and compared with calculated arithmetic methods (ABC/2, ABC/2.4, ABC/3, and 2/3SC) volumes. Volumes were compared by difference plots for specific groups: randomization ICH (n=374), 3- to 7-day postsurgical ICH (n=206), antithrombotic-associated ICH (n=79), irregular-shape ICH (n=703) and irregular-density ICH (n=650). Density and shape were measured by the Barras ordinal shape and density groups (1-5).
RESULTS
The ABC/2.4 method had the closest agreement to the semiautomatic segmentation volume in all groups, except for the 3- to 7-day postsurgical ICH group where the ABC/3 method was superior.
CONCLUSIONS
Although the ABC/2 formula for calculating elliptical ICH is well validated, it must be used with caution in ICH scans where the elliptical shape of ICH is a false assumption. We validated the adjustment of the ABC/2.4 method in randomization, antithrombotic-associated, heterogeneous-density, and irregular-shape ICH.
CLINICAL TRIAL REGISTRATION
URL: http://www.isrctn.com/ISRCTN22153967. Unique identifier: ISRCTN22153967.
背景与目的
ABC/2 法计算脑内血肿（ICH）体积已得到充分验证。然而，该公式源自于椭圆体积的计算，假设 ICH 的形状为椭圆形。我们通过 STICH II 队列的回顾性分析（早期手术与自发性幕上脑叶脑出血患者初始保守治疗的比较）来比较 ABC/2 公式与其他方法的一致性。
方法
从 390 例患者中，根据 STICH II 图像档案中是否存在符合 OsiriX DICOM 查看器的 CT 扫描，选择了 739 个扫描。通过 OsiriX 软件中的参考标准半自动分割来计算 ICH 体积，并与计算的算术方法（ABC/2、ABC/2.4、ABC/3 和 2/3SC）体积进行比较。对于特定的组，通过差异图比较体积：随机分组 ICH（n=374）、术后 3-7 天 ICH（n=206）、抗血栓相关 ICH（n=79）、形状不规则 ICH（n=703）和密度不均匀 ICH（n=650）。通过 Barras 序数形状和密度组（1-5）测量密度和形状。
结果
除术后 3-7 天 ICH 组外，ABC/3 方法优于 ABC/2.4 方法，在所有组中，ABC/2.4 方法与半自动分割体积的一致性最好。
结论
虽然用于计算椭圆形 ICH 的 ABC/2 公式得到了充分验证，但在假设 ICH 为椭圆形的情况下，必须谨慎使用 ICH 扫描。我们验证了 ABC/2.4 方法在随机分组、抗血栓相关、异质密度和形状不规则 ICH 中的调整。
临床试验注册
网址：http://www.isrctn.com/ISRCTN22153967。独特标识符：ISRCTN22153967。
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