ABC/2和Slicer测量体积差值对脑内血肿体积扩大的预测  

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

作　　者：伍刚 刘广韬 翁宇[3] 扎多[3] 王洪国 周青 刘策 刘如恩[1] Wu Gang;Liu Guangtao;Weng Yu;Zha Duo;Wang Hongguo;Zhou Qing;Liu Ce;Liu Ru'en(Department of Neurosurgery,Peking University People’s Hospital,Beijing 100044,China;Department of Neurosurgery,Chinese PLA General Hospital 8th Medical Center,Beijing 100091,China;Department of Neurosurgery,Tibet Autonomous Region People’s Hospital,Lhasa 850000,China)

机构地区：[1]北京大学人民医院神经外科,100044 [2]中国人民解放军总医院第八医学中心神经外科,北京100091 [3]西藏自治区人民医院神经外科,拉萨850000

出　　处：《中华临床医师杂志（电子版）》2020年第3期192-196,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：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 cm^3;血肿体积扩大≥12.5 cm^3)。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 cm^3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 cm^3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。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.

关 键 词：脑出血 血肿体积扩大 血肿形状分类 3D Slicer 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]