Abstract
Background: Our purpose was to establish a noninvasive quantitative method for assessing intracranial pressure (ICP) levels in patients with traumatic brain injury (TBI) through investigating the Hounsfield unit (HU) features of computed tomography (CT) images. Methods: In this retrospective study, 47 patients with a closed TBI were recruited. Hounsfield unit features from the last cranial CT and the initial ICP value were collected. Three models were established to predict intracranial hypertension with Hounsfield unit (HU model), midline shift (MLS model), and clinical expertise (CE model) features. Results: The HU model had the highest ability to predict intracranial hypertension. In 34 patients with unilateral injury, the HU model displayed the highest performance. In three classifications of intracranial hypertension (ICP ≤ 22, 23–29, and ≥30 mmHg), the HU model achieved the highest F1 score. Conclusions: This radiological feature-based noninvasive quantitative approach showed better performance compared with conventional methods, such as the degree of midline shift and clinical expertise. The results show its potential in clinical practice and further research.
Highlights
Traumatic brain injury (TBI) is a major public health problem around the world
Inclusion criteria were as follows: (1) patients with an acute closed TBI; (2) received invasive intracranial pressure (ICP) monitoring according to the guidelines for the management of severe traumatic brain injury; (3) received emergency cranial computed tomography (CT) scan within 60 min of ICP monitoring; (4) 18–65 years old
* The precision, recall, and F1 score were calculated using weighted averages of each category. This retrospective study enrolled closed TBI patients, who received a cranial CT scan within 60 min of ICP monitoring to ensure the timeliness of CT images
Summary
Traumatic brain injury (TBI) is a major public health problem around the world. It is estimated that 69 million individuals worldwide suffer a TBI each year, leading to death or life-long disability [1]. The purpose of this study was to noninvasively evaluate the ICP of patients in an early phase before surgery using the Hounsfield unit (HU) method. This method was used to establish a model by extracting the HU value and its related features, which can reflect the symmetry, uniformity, and local intensity distribution changes of CT images, so as to evaluate intracranial pressure. Our purpose was to establish a noninvasive quantitative method for assessing intracranial pressure (ICP) levels in patients with traumatic brain injury (TBI) through investigating the Hounsfield unit (HU) features of computed tomography (CT) images. In 34 patients with unilateral injury, the HU model displayed the highest performance
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