Abstract
The association between intracerebral hemorrhage (ICH) shape and a poor treatment outcome has been established by few authors. We decided to analyze whether computationally assessed hemorrhage shape irregularity is associated with any known predictors of its poor treatment outcome. We retrospectively analyzed 48 patients with spontaneous intracerebral hemorrhage. For each patient we calculated Fractal Dimension, Compactness, Fourier Factor and Circle Factor. Our study showed that patients above 65 years old had significantly higher Compactness (0.70 ± 0.19 vs. 0.56 ± 0.20; p < 0.01), Fractal Dimension (0.46 ± 0.22 vs. 0.32 ± 0.20; p = 0.03) and Circle Factor (0.51 ± 0.25 vs. 0.35 ± 0.17; p < 0.01). Patients with hemorrhage growth had significantly higher Compactness (0.74 ± 0.23 vs. 0.58 ± 0.18; p < 0.01), Circle Factor (0.55 ± 0.27 vs. 0.37 ± 0.18; p < 0.01) and Fourier Factor (0.96 ± 0.06 vs. 0.84 ± 0.19; p = 0.03). In conclusion, irregularity resulting from the number of appendices can be a predictor of ICH growth; however, the size of those appendices is also important. Shape roughness better reflects the severity of brain tissue damage and a patient’s general condition.
Highlights
Spontaneous intracerebral hemorrhage (ICH) is a devastating type of stroke with a 30-day mortality rate of 30%–55% [1,2,3,4]
Based on CT scans, we found that the average C = 0.66 ± 0.11, the average Fourier Factor (FF) = 0.87 ± 0.11, the average Fractal Dimension (FD) = 1.36 ± 0.13 and the average Circle Factor (CF) = 3.20 ± 0.94
In receiver operative characteristics (ROC) curve analysis, we found that the area under curve (AUC) was highest for FF (AUC = 0.814), followed by CF (AUC = 0.721), C (AUC = 0.716) and FD (AUC = 0.639) (Figure 2)
Summary
Spontaneous intracerebral hemorrhage (ICH) is a devastating type of stroke with a 30-day mortality rate of 30%–55% [1,2,3,4]. It is important to establish factors that might predict a poor outcome of treatment, especially since management options for ICH remain restricted [5,6]. These predictors include poor neurological status upon admission, older age and arterial hypertension [7,8,9]. In our previous study, which concerned the computer-aided, objective analysis of ICH shape, we found that such shape irregularity can be independently correlated with a worse treatment outcome [10]. Mechanisms of such association are still inconclusive. One of the explanations can be found in a study by Barras et al [11], which showed that ICH shape irregularity can be related to the risk of
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