Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
World Neurosurg. 2021 Feb;146:e829-e836. doi: 10.1016/j.wneu.2020.11.025. Epub 2020 Nov 12.
Hounsfield unit (HU) of perihematomal edema (PHE) may be a predictor of prognosis of intracerebral hemorrhage (ICH). Our study evaluated whether PHE mean HU at the 72 hours after ICH predicts outcome, and how it compares against other PHE measures.
Patients with ICH from a tertiary medical institution were included. PHE was segmented by the semiautomatic plane method to measure volume and mean HU. Outcomes of interest was poor 90-day prognosis (modified Rankin Scale score ≥3). Logistic regression was used to assess relationships with outcome.
Data from a total of 159 patients with ICH were collected. The median mean HU of PHE at 72 hours was 22.1 (IQR: 19.2-25.0). Binary logistic regression showed that the 72-hour PHE mean HU was negatively correlated with the poor prognosis of patients with ICH (OR 0.59, 95% CI 0.47-0.75, P < 0.05). The receiver operator curves of meaningful indicators revealed that the area under the curve (AUC) of PHE mean HU at 72 hours was larger and the difference of AUC between PHE mean HU with PHE absolute volume or extension distance were statistically significant (P < 0.05). The 72-hour PHE mean HU has a higher value in predicting adverse prognosis of patients with ICH.
The PHE mean HU at 72 hours was negatively correlated with the poor prognosis of patients with ICH. The prediction ability of PHE mean HU at 72 hours was better than PHE absolute volume and extension distance, contributing to a rather good index for predicting outcome of ICH.
血肿周围水肿（PHE）的 Hounsfield 单位（HU）可能是预测脑出血（ICH）预后的指标。本研究评估了 ICH 后 72 小时 PHE 的平均 HU 是否可以预测预后，以及与其他 PHE 测量值相比如何。
纳入了来自三级医疗机构的 ICH 患者。使用半自动平面法对 PHE 进行分割以测量体积和平均 HU。感兴趣的结局是不良的 90 天预后（改良 Rankin 量表评分≥3）。使用逻辑回归评估与结局的关系。
共收集了 159 例 ICH 患者的数据。72 小时 PHE 平均 HU 的中位数为 22.1（IQR：19.2-25.0）。二元逻辑回归显示，72 小时 PHE 平均 HU 与 ICH 患者预后不良呈负相关（OR 0.59，95%CI 0.47-0.75，P<0.05）。有意义指标的受试者工作特征曲线显示，72 小时 PHE 平均 HU 的曲线下面积（AUC）更大，且 PHE 平均 HU 与 PHE 绝对体积或延伸距离的 AUC 之间的差异具有统计学意义（P<0.05）。72 小时 PHE 平均 HU 对预测 ICH 患者不良预后的价值更高。
72 小时 PHE 平均 HU 与 ICH 患者预后不良呈负相关。72 小时 PHE 平均 HU 的预测能力优于 PHE 绝对体积和延伸距离，是预测 ICH 结局的一个较好指标。
