Quantitative analysis of computed tomography images and early detection of cerebral edema for pediatric traumatic brain injury patients: retrospective study

被引:32
作者
Kim, Hakseung [1 ]
Kim, Gwang-dong [2 ]
Yoon, Byung C. [3 ]
Kim, Keewon [2 ]
Kim, Byung-Jo [4 ]
Choi, Young Hun [5 ]
Czosnyka, Marek [6 ]
Oh, Byung-Mo [2 ]
Kim, Dong-Joo [1 ,6 ]
机构
[1] Korea Univ, Dept Brain & Cognit Engn, Seoul 136713, South Korea
[2] Seoul Natl Univ, Coll Med, Dept Rehabil Med, Seoul, South Korea
[3] Stanford Univ, Sch Med, Dept Neurosurg, Stanford, CA USA
[4] Korea Univ, Coll Med, Dept Neurol, Seoul 136705, South Korea
[5] Seoul Natl Univ, Childrens Hosp, Dept Radiol, Seoul, South Korea
[6] Univ Cambridge, Sch Clin, Acad Neurosurg Unit, Cambridge, England
基金
新加坡国家研究基金会;
关键词
Cerebral edema; Computed tomography; Densitometry; Traumatic brain injury; Pediatrics; HISTOGRAM ANALYSIS; VASOGENIC EDEMA; LUNG DENSITY; HEAD-INJURY; ARTERY OCCLUSION; CT DENSITOMETRY; CHILDREN; CLASSIFICATION; MYELINATION; PREDICTION;
D O I
10.1186/s12916-014-0186-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The purpose of this study was to identify whether the distribution of Hounsfield Unit (HU) values across the intracranial area in computed tomography (CT) images can be used as an effective diagnostic tool for determining the severity of cerebral edema in pediatric traumatic brain injury (TBI) patients. Methods: CT images, medical records and radiology reports on 70 pediatric patients were collected. Based on radiology reports and the Marshall classification, the patients were grouped as mild edema patients (n = 37) or severe edema patients (n = 33). Automated quantitative analysis using unenhanced CT images was applied to eliminate artifacts and identify the difference in HU value distribution across the intracranial area between these groups. Results: The proportion of pixels with HU = 17 to 24 was highly correlated with the existence of severe cerebral edema (P < 0.01). This proportion was also able to differentiate patients who developed delayed cerebral edema from mild TBI patients. A significant difference between deceased patients and surviving patients in terms of the HU distribution came from the proportion of pixels with HU = 19 to HU = 23 (P < 0.01). Conclusions: The proportion of pixels with an HU value of 17 to 24 in the entire cerebral area of a non-enhanced CT image can be an effective basis for evaluating the severity of cerebral edema. Based on this result, we propose a novel approach for the early detection of severe cerebral edema.
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页数:16
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