ABC/2和Slicer测量体积差值对脑内血肿体积扩大的预测

目的探讨一种预测脑出血（ICH）血肿体积扩大的新方法。 方法分析128例自发性脑内血肿的CT扫描图像。使用ABC/2方法和3D Slicer软件测量血肿体积，计算差值并与血肿形状分类比较其预测血肿体积扩大的效能（血肿体积扩大≥6.0 cm³；血肿体积扩大≥12.5 cm³）。 结果患者首次头颅CT扫描用ABC/2法测量的ICH血肿体积［（21.4±16.4）ml］较3D Slicer法［（17.7±14.0）ml］测量值大，差异有统计学意义（t=11.869，P<0.001）；患者第2次头颅CT扫描采用ABC/2方法［（26.3±21.8）ml］测量ICH血肿体积较同一方法首次测量值大［（21.4±16.4）ml］，差异有统计学意义（t=8.599，P<0.001）。ABC/2法与3D Slicer法测量的ICH血肿体积差值与规则形（r=0.628，P<0.05）、不规则形（r=0.603，P<0.05）、多叶形血肿体积扩大（r=0.591，P<0.05）均具有相关性。首次头颅CT扫描ABC/2法与3D Slicer法测量血肿体积的差值预测血肿体积扩大≥6.0 cm³的曲线下面积大于血肿形态的曲线下面积（0.866 vs 0.755，Z=2.496，P=0.013）；首次头颅CT扫描ABC/2法与3D Slicer法测量血肿体积的差值预测血肿体积扩大≥12.5 cm³的曲线下面积大于血肿形态的曲线下面积（0.911 vs 0.731，Z=2.674，P=0.008）。 结论与血肿形状类别相比，ABC/2和3D Slicer测量的体积差异可以更好地预测血肿的扩大。

Predicting intracerebral hematoma expansion based on difference of hematoma volumes measured using ABC/2 and 3D Slicer

Objective To provide a new method for predicting hematoma expansion in cerebral hemorrhage(ICH).Methods Initial CT scan images of 128 patients with spontaneous intracerebral hematoma were analyzed.Hematoma volumes were measured using the ABC/2 method and 3D Slicer.The difference of hematoma volume was calculated to predict hematoma expansion,and its predictive efficiency was compared with that of hematoma shape categories(hematoma expansion≥6.0 cm^3 growth;≥12.5 cm^3 growth).Results The hematoma volume initially measured using the ABC/2 method and 3D Slicer was(21.4±16.4)cm^3 and(17.7±14.0)cm3,respectively.The hematoma volume measured by the ABC/2 method was significantly larger than that using 3D Slicer(t=11.869,P<0.001).The volume of ICH hematoma measured by the ABC/2 method(26.3±21.8)ml]at the second CT scan was significantly larger than that at the first scan(21.4±16.4)ml,t=8.599,P<0.001].The difference of ICH hematoma volume measured using the ABC/2 method and 3D Slicer was correlated with regular(r=0.628,P<0.05),irregular(r=0.603,P<0.05),and multiple lobular hematoma expansion(r=0.591,P<0.05).The areas under the curve of hematoma volume difference between ABC/2 and 3D Slicer at the first scan for predicting hematoma expansion≥6.0 cm^3 and≥12.5 cm^3 were both greater than those of hematoma shape category(0.866 vs 0.755,Z=2.496,P=0.013;0.911 vs 0.731,Z=2.674,P=0.008).Conclusion Compared to hematoma shape category,the difference of hematoma volume measured using ABC/2 and 3D slicer could better predict the hematoma expansion.