Early prediction of clinical outcomes in patients with aneurysmal subarachnoid hemorrhage using computed tomography texture analysis
Early prediction of clinical outcomes in patients with aneurysmal subarachnoid hemorrhage using computed tomography texture analysis
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DOI：
10.1016/j.jocn.2019.08.098
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发表时间：
2020-01-01
影响因子：
2
通讯作者：
Yoshida, Kazunari
中科院分区：
文献类型：
--
作者：
Kanazawa, Tokunori;Takahashi, Satoshi;Yoshida, Kazunari
蛛网膜下腔出血 (SAH) 的放射学评估通常会受到观察者间差异的影响。本研究的目的是通过商用软件程序和常规 CT 图像，使用定量 CT 纹理分析 (CTTA) 来回顾性检测发作后早期的计算机断层扫描 (CT) 纹理参数，以预测脑血管痉挛、迟发性脑缺血 (DCI) 和动脉瘤性蛛网膜下腔出血的功能结果。对四年来在庆应义塾大学医院接受手术治疗的 40 名动脉瘤性蛛网膜下腔出血患者进行了分析。使用市售软件程序（Synapse Vincent）进行 CT 纹理分析。评估蛛网膜下腔血凝块和脑水肿的以下纹理参数：平均CT值、熵、偏度和峰度。蛛网膜下腔血栓的平均 CT 值与脑血管痉挛、 DCI 和功能结果显着相关。平均 CT 值 >= 49.64 Hounsfield 单位 (HU) 预测脑血管痉挛的敏感性和特异性分别为 85.7% 和 61.5%（曲线下面积 [AUC] = 0.758）。平均 CT 值 >= 49.95 HU 预测 DCI 的敏感性和特异性分别为 100% 和 60.6% (AUC = 0.810)。平均 CT 值 >= 53.00 HU 预测功能结果不佳，敏感性和特异性分别为 56.3% 和 91.7% (AUC = 0.747)。使用市售软件程序的 CTTA 表明，发作后早期状态下蛛网膜下腔血栓的平均 CT 值可以以高敏感性和特异性预测血管痉挛、DCI 和临床结果。 (C) 2019 Elsevier Ltd. 保留所有权利。
Radiological evaluation of subarachnoid hemorrhage (SAH) is often subject to interobserver variability. The aim of this study was to retrospectively detect computed tomography (CT) texture parameters in the early postictal state to predict cerebral vasospasm, delayed cerebral ischemia (DCI), and functional outcome in aneurysmal SAH using quantitative CT texture analysis (CTTA) via a commercially available software program and routine CT images. 40 patients with aneurysmal SAH surgically treated at the Keio University Hospital during a four-year period were analyzed. CT texture analyses were performed using a commercially available software program (Synapse Vincent). The following texture parameters of blood clots in the subarachnoid space and cerebral edema were assessed: mean CT value, entropy, skewness, and kurtosis. The mean CT value of blood clots in the subarachnoid space was significantly associated with cerebral vasospasm, DCI, and functional outcome. The mean CT value >= 49.64 Hounsfield units (HU) predicted cerebral vasospasm with a sensitivity and specificity of 85.7% and 61.5%, respectively (area under the curve [AUC] = 0.758). The mean CT value >= 49.95 HU predicted DCI with a sensitivity and specificity of 100% and 60.6%, respectively (AUC = 0.810). The mean CT value >= 53.00 HU predicted poor functional outcome with a sensitivity and specificity of 56.3% and 91.7%, respectively (AUC = 0.747). CTTA using a commercially available software program demonstrated that the mean CT value of clots in the subarachnoid space in the early postictal state could predict vasospasm, DCI, and clinical outcome with a high sensitivity and specificity. (C) 2019 Elsevier Ltd. All rights reserved.