Department of Neurosurgery, University Hospital, Goethe-University, Frankfurt am Main, Germany.
Deparment of Neuroradiology, University Hospital, Goethe-University, Frankfurt am Main, Germany.
PLoS One. 2018 Jun 26;13(6):e0199809. doi: 10.1371/journal.pone.0199809. eCollection 2018.
Subdural hematoma (SDH) is a common disease associated with high morbidity, which is becoming more prominent due to the increasing incidence. Decision for a surgical evacuation is made depending on the clinical appearance and the volume of SDH, wherefore it is important to have a simple 'bedside' method to measure and compare the volume of SDH.
The aim of the study was to verify the accuracy of the simplified ABC/2 volumetric formula to determine a valuable tool for the clinical practice.
Preoperative CT-scans of 83 patients with SDHs were used for the computer-assisted volumetric measurement via BrainLab® as well as the ABC/2 volumetric measurement. A = largest length (anterior to posterior) of the SDH; B = maximum width (lateral to midline) 90° to A; C = maximum height (coronal plane or multiplication of slices) of the hematoma. These measurements were performed by two independent clinicians in a blinded fashion. Both volumes were compared by linear regression analysis of Pearson and Bland-Altman regression analysis.
Among 100 SDHs, 53% were under an 47% were over 100cm3 showing a well distribution of the hematoma sizes. There was an excellent correlation between computer-assisted volumetric measurement and ABC/2 (R2 = 0.947, p<0.0001) and no undesirable deviation and trend were detected (p = 0.101; p = 0.777). A 95% tolerance region of the ratios of both methods was [0.805-1.201].
The ABC/2 method is a simple and fast bedside formula for the measurement of SDH volume in a timely manner without limited access through simple adaption, which may replace the computer-assisted volumetric measurement in the clinical and research area. Reason for the good accuracy seems to be the spherical form of SDH, which has a similarity to a half ellipsoid.
硬膜下血肿（SDH）是一种常见的高发病率疾病，由于发病率的增加，其发病率越来越高。是否进行手术清除取决于临床症状和 SDH 的体积，因此，拥有一种简单的“床边”方法来测量和比较 SDH 的体积非常重要。
本研究旨在验证简化的 ABC/2 体积公式的准确性，以确定一种对临床实践有价值的工具。
使用 BrainLab®对 83 例 SDH 患者的术前 CT 扫描进行计算机辅助体积测量以及 ABC/2 体积测量。A = SDH 的最大长度（从前到后）；B = 90°到 A 的最大宽度（外侧到中线）；C = 血肿的最大高度（冠状面或切片的乘积）。这两个测量值由两名独立的临床医生进行盲法测量。通过 Pearson 线性回归分析和 Bland-Altman 回归分析比较两种体积。
在 100 个 SDH 中，53%的 SDH 体积小于 100cm3，47%的 SDH 体积大于 100cm3，血肿大小分布均匀。计算机辅助体积测量与 ABC/2 之间具有极好的相关性（R2 = 0.947，p<0.0001），并且未检测到不良偏差和趋势（p = 0.101；p = 0.777）。两种方法比值的 95%容忍区间为[0.805-1.201]。
ABC/2 方法是一种简单、快速的床边公式，可以及时测量 SDH 体积，无需通过简单的适应性限制访问，它可能会在临床和研究领域取代计算机辅助体积测量。该方法具有良好的准确性，原因可能是 SDH 的球形形态与半椭圆相似。
