Density and Shape as CT Predictors of Intracerebral Hemorrhage Growth
Density and Shape as CT Predictors of Intracerebral Hemorrhage Growth
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DOI：
10.1161/strokeaha.108.536888
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发表时间：
2009-04-01
期刊：
影响因子：
8.3
通讯作者：
Davis, Stephen M.
中科院分区：
文献类型：
--
作者：
Barras, Christen D.;Tress, Brian M.;Davis, Stephen M.
背景和目的——脑出血（ICH）的增长可预测死亡率和功能结果。我们假设，不规则的血肿形状和密度异质性（反映活动性、多灶性出血或可变的出血时程）可以预测 ICH 的生长。 方法 - 三名评估者检查了 ICH 中重组激活因子 VII 的 Ilb 期试验安慰剂组中 90 名患者的基线 3 小时内 CT 脑扫描。每个评估者在不了解生长数据的情况下，独立地将密度和形状的新 5 点分类尺度应用于随机呈现的 ICH 基线 CT 图像。密度和形状被定义为均匀/规则（类别 I 至 2）或异质/不规则（类别 3 至 5）。确定这些量表的评估者内部和评估者之间的可靠性。生长被评估为连续变量并使用 3 个二元定义：(1) 任何 ICH 生长； (2) ICH生长≥33%或≥12.5mL； (3) 基线和 24 小时 CT 扫描之间的径向生长 >1 圈。患者被分为基线 ICH 体积的三分位数：“小”（0 至 10 mL）、“中”（10 至 25 mL）和“大”（25 至 106 mL）。 结果 - 新量表的评估者间和评估者内一致性超过 85%（+/- 1 类）。与小体积组相比，大体积组的中位生长显着更高（P
Background and Purpose-Intracerebral hemorrhage (ICH) growth predicts mortality and functional outcome. We hypothesized that irregular hematoma shape and density heterogeneity, reflecting active, multifocal bleeding or a variable bleeding time course, would predict ICH growth.Methods-Three raters examined baseline sub-3-hour CT brain scans of 90 patients in the placebo arm of a Phase Ilb trial of recombinant activated Factor VII in ICH. Each rater, blinded to growth data, independently applied novel 5-point categorical scales of density and shape to randomly presented baseline CT images of ICH. Density and shape were defined as either homogeneous/regular (Category I to 2) or heterogeneous/irregular (Category 3 to 5). Within- and between-rater reliability was determined for these scales. Growth was assessed as a continuous variable and using 3 binary definitions: (1) any ICH growth; (2) >= 33% or >= 12.5 mL ICH growth; and (3) radial growth >1 turn between baseline and 24-hour CT scan. Patients were divided into tertiles of baseline ICH volume: "small" (0 to 10 mL), "medium" (10 to 25 mL), and "large" (25 to 106 mL).Results-Inter- and intrarater agreements for the novel scales exceeded 85% (+/- 1 category). Median growth was significantly higher in the large-volume group compared with the small group (P