Department of Neurology, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, China.
Department of Neurosurgery, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, No.29, Xinglong Lane, Jiangsu, 213003, Changzhou, China.
BMC Neurol. 2022 Dec 5;22(1):452. doi: 10.1186/s12883-022-02983-w.
Irregular hematoma is considered as a risk sign of hematoma expansion. The aim of this study was to quantify hematoma irregularity with computed tomography based on 3D Slicer.
Patients with spontaneous intracerebral hemorrhage who underwent an initial and subsequent non-contrast computed tomography (CT) at a single medical center between January 2019 to January 2020 were retrospectively identified. The Digital Imaging and Communication in Medicine (DICOM) standard images were loaded into the 3D Slicer, and the surface area (S) and volume (V) of hematoma were calculated. The hematoma irregularity index (HII) was defined as [Formula: see text]. Logistic regression analyses and receiver operating characteristic (ROC) curve analysis were performed to assess predictive performance of HII.
The enrolled patients were divided into those with hematoma enlargement (n = 36) and those without the enlargement (n = 57). HII in hematoma expansion group was 130.4 (125.1-140.0), and the index in non-enlarged hematoma group was 118.6 (113.5-122.3). There was significant difference in HII between the two groups (P < 0.01). Multivariate logistic regression analysis revealed that the HII was significantly associated with hematoma expansion before (odds ratio = 1.203, 95% confidence interval [CI], 1.115-1.298; P < 0.001) and after adjustment for age, hematoma volume, Glasgow Coma Scale score (odds ratio = 1.196, 95% CI, 1.102-1.298, P < 0.001). The area under the ROC curve was 0.86 (CI, 0.78-0.93, P < 0.01), and the best cutoff of HII for predicting hematoma growth was 123.8.
As a quantitative indicator of irregular hematoma, HII can be calculated using the 3D Slicer. And the HII was independently correlated with hematoma expansion.
不规则血肿被认为是血肿扩大的风险标志。本研究旨在使用基于 3D Slicer 的计算机断层扫描来量化血肿的不规则性。
回顾性分析了 2019 年 1 月至 2020 年 1 月期间在单一医疗中心接受初始和后续非对比计算机断层扫描（CT）的自发性脑出血患者。将数字成像和通信标准图像（DICOM）加载到 3D Slicer 中，并计算血肿的表面积（S）和体积（V）。血肿不规则指数（HII）定义为[公式：见正文]。采用逻辑回归分析和受试者工作特征（ROC）曲线分析评估 HII 的预测性能。
纳入的患者分为血肿扩大组（n=36）和无扩大组（n=57）。血肿扩大组的 HII 为 130.4（125.1-140.0），非扩大血肿组的 HII 为 118.6（113.5-122.3）。两组间 HII 差异有统计学意义（P<0.01）。多变量逻辑回归分析显示，HII 与血肿扩大前（比值比=1.203，95%置信区间[CI]，1.115-1.298；P<0.001）和调整年龄、血肿量、格拉斯哥昏迷量表评分后（比值比=1.196，95%CI，1.102-1.298，P<0.001）显著相关。ROC 曲线下面积为 0.86（CI，0.78-0.93，P<0.01），HII 预测血肿生长的最佳截断值为 123.8。
作为血肿不规则的定量指标，HII 可使用 3D Slicer 计算。并且 HII 与血肿扩大独立相关。
