Chan David Yuen Chung, Cheung Eric Yuk Hong, Hui Ka Ho, Leung Cecelia Mei Sze, Ng Stephanie Chi Ping, Mak Wai Kit, Wong George Kwok Chu, Chan Tat Ming Danny, Poon Wai Sang
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.
Chin Neurosurg J. 2022 Aug 3;8(1):18. doi: 10.1186/s41016-022-00287-z.
Postoperative pneumocephalus is associated with a higher risk of recurrence of chronic subdural hematoma (cSDH). However, there is no verified simple way to measure the pneumocephalus volume at the bedside for daily clinical use. The ABC/2 method was shown to be a simple and reliable technique to estimate volumes of intracranial lesions, such as intracranial hematomas. This study aims to evaluate the accuracy of the ABC/2 formula in estimating volumes of pneumocephalus, as compared to the gold standard with computer-assisted volumetric analysis.
A total of 141 postoperative computed tomographic (CT) brain scans of cSDH patients with burr-hole drainage were analysed. Pneumocephalus volume was measured independently by both the ABC/2 formula and the computer-assisted volumetric measurement. For the computer-assisted measurement, the volume of the air was semiautomatically segmented and calculated by computer software. Linear regression was used to determine the correlation between the ABC/2 method and computer-assisted measurement.
The postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage (29.34 ml versus 12.21 ml, p < 0.001). The estimated volumes by the formula ABC/2 significantly correlated to the volumes as measured by the computer-assisted volumetric technique, with r = 0.992 (p < 0.001). The Pearson correlation coefficient is very close to 1, which signifies a very strong positive correlation, and it is statistically significant.
An excellent correlation is observed between the ABC/2 method and the computer-assisted measurement. This study verified that the ABC/2 method is an accurate and simple "bedside" technique to estimate pneumocephalus volume.
术后气颅与慢性硬膜下血肿（cSDH）复发风险较高相关。然而，目前尚无经证实的简便方法可在床边测量气颅体积以供日常临床使用。ABC/2法被证明是一种用于估计颅内病变（如颅内血肿）体积的简单可靠技术。本研究旨在与计算机辅助容积分析这一金标准相比，评估ABC/2公式在估计气颅体积方面的准确性。
共分析了141例接受钻孔引流的cSDH患者的术后脑部计算机断层扫描（CT）图像。气颅体积分别通过ABC/2公式和计算机辅助容积测量独立进行测量。对于计算机辅助测量，空气体积由计算机软件进行半自动分割和计算。采用线性回归确定ABC/2法与计算机辅助测量之间的相关性。
双侧钻孔引流术后的气颅体积显著大于单侧钻孔引流术后的气颅体积（29.34 ml对12.21 ml，p < 0.001）。ABC/2公式估计的体积与计算机辅助容积技术测量的体积显著相关，r = 0.992（p < 0.001）。皮尔逊相关系数非常接近1，这表明存在非常强的正相关，且具有统计学意义。
ABC/2法与计算机辅助测量之间存在极好的相关性。本研究证实ABC/2法是一种准确且简便的“床边”技术，可用于估计气颅体积。
