Kliś Kornelia M, Krzyżewski Roger M, Kwinta Borys M, Stachura Krzysztof, Gąsowski Jerzy
Faculty of Computer Science, Electronics and Telecommunications, AGH University of Science and Technology, Kraków, Poland; Jagiellonian University Medical College, Kraków, Poland.
Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland.
World Neurosurg. 2018 Dec;120:e863-e869. doi: 10.1016/j.wneu.2018.08.178. Epub 2018 Sep 3.
Shape and density of intracerebral hemorrhage (ICH) are associated with a higher risk of poor treatment outcome. However, methods of assessment for the features are still inconclusive. Therefore, we decided to measure ICH shape irregularity using shape factors to achieve objective results.
We retrospectively analyzed 48 patients with spontaneous ICH confirmed by head computed tomography (CT) scan. We obtained detailed medical history and blood test results from medical records. On admission patients were assessed using Glasgow Coma Scale score, and on discharge patients were assessed using Glasgow Outcome Scale (GOS) score. GOS score of less than 3 was defined as poor outcome. For each slice of CT scan with visible ICH, we extracted its contour and calculated the fractal dimension (FD), compactness (C), and Fourier factor (FF). We also calculated the circle factor (CF), which was defined as the contour perimeter/perimeter of the biggest circle that can be inscribed into the contour, and density heterogeneity, defined as the variance of pixel density.
A total of 28 patients (58.33%) had poor treatment outcome. Those patients had significantly higher C (0.71 ± 0.09 vs. 0.59 ± 0.09; P < 0.01), FD (1.42 ± 0.12 vs. 1.27 ± 0.09; P < 0.01), and CF (3.59 ± 0.92 vs. 2.63 ± 0.63; P < 0.01). In multivariate logistic regression analysis, FD (odds ratio, 4.176; 95% confidence interval, 1.551-15.577; P = 0.012) remained independently associated with higher risk of poor treatment outcome.
Each of the shape descriptors, except FF, was associated with treatment outcome after ICH. FD can be used as an independent predictor of outcome.
脑出血（ICH）的形状和密度与治疗效果不佳的风险较高相关。然而，针对这些特征的评估方法仍无定论。因此，我们决定使用形状因子来测量ICH形状不规则性，以获得客观结果。
我们回顾性分析了48例经头颅计算机断层扫描（CT）确诊的自发性ICH患者。我们从病历中获取了详细的病史和血液检查结果。入院时使用格拉斯哥昏迷量表评分对患者进行评估，出院时使用格拉斯哥预后量表（GOS）评分对患者进行评估。GOS评分小于3被定义为预后不良。对于每一层可见ICH的CT扫描，我们提取其轮廓并计算分形维数（FD）、紧致度（C）和傅里叶因子（FF）。我们还计算了圆形因子（CF），其定义为轮廓周长/可内切于轮廓的最大圆的周长，以及密度异质性，定义为像素密度的方差。
共有28例患者（58.33%）治疗效果不佳。这些患者的C（0.71±0.09 vs. 0.59±0.09；P<0.01）、FD（1.42±0.12 vs. 1.27±0.09；P<0.01）和CF（3.59±0.92 vs. 2.63±0.63；P<0.01）显著更高。在多因素逻辑回归分析中，FD（比值比，4.176；95%置信区间，1.551 - 15.577；P = 0.012）仍然独立地与治疗效果不佳的较高风险相关。
除FF外，每个形状描述符都与ICH后的治疗效果相关。FD可作为预后的独立预测指标。
