Skip to main content
Top

Open Access 26-04-2024 | Original Article

Association of Imaging-based Predictors with Outcome in Different Treatment Options for Intracerebral Hemorrhage

Authors: Roger M. Krzyżewski, Borys M. Kwinta, Krzysztof Stachura, Tadeusz J. Popiela, Roman Pułyk, Agnieszka Słowik, Jerzy Gąsowski, Kornelia M. Kliś

Published in: Clinical Neuroradiology

Login to get access

Abstract

Purpose

Intracerebral hemorrhage is the deadliest form of stroke. This study aimed to enhance the prediction of 30-day mortality in intracerebral hemorrhage patients by integrating computational parameters.

Methods

This study retrospectively analyzed 435 patients with spontaneous intracerebral hemorrhage (ICH). Utilizing the acquired computed tomography (CT) images, we extracted the contour and visual representation of ICH. For the extracted contour, the analysis encompassed factors including compactness, fractal dimension, Fourier factor, and circle factor. For the images depicting ICH, we calculated various factors related to density distribution including mean, coefficient of variance, skewness and kurtosis, as well as texture parameters, such as energy, entropy, contrast and homogeneity. To assess the impact of surgical treatment on 30-day mortality, logistic regression analysis was used.

Results

A total of 126 patients (29.09%) died within 30 days. A total of 62 (14.25%) patients underwent surgical treatment. Multivariate logistic regression analysis revealed that surgical treatment was independently associated with a lower risk of 30-day mortality (odds ratio, OR 0.226, 95% confidence interval, CI 0.049–0.85; p = 0.039). Based on the moderated analysis, we found that the volume of ICH (OR 0.905, 95% CI 0.902–0.908; p < 0.001) and ICH energy (OR 1.389, 95%CI 0.884–0.988; p = 0.010) had positive moderating effect on such associations while the presence of intraventricular blood had negative moderating effect (OR 1.154, 95% CI 1.034–1.628; p = 0.010).

Conclusion

Patients exhibiting a higher volume and energy of ICH might benefit from surgical treatment; however, this efficacy was found to be diminished in cases involving the presence of intraventricular blood.
Appendix
Available only for authorised users
Literature
1.
go back to reference Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383:245.CrossRefPubMedPubMedCentral Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383:245.CrossRefPubMedPubMedCentral
2.
go back to reference Pinho J, Costa AS, Araújo JM, Amorim JM, Ferreira C. Intracerebral hemorrhage outcome: A comprehensive update. J Neurol Sci. 2019;398:54–66.CrossRefPubMed Pinho J, Costa AS, Araújo JM, Amorim JM, Ferreira C. Intracerebral hemorrhage outcome: A comprehensive update. J Neurol Sci. 2019;398:54–66.CrossRefPubMed
3.
go back to reference van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010;9:167–76.CrossRefPubMed van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010;9:167–76.CrossRefPubMed
4.
go back to reference Veltkamp R, Purrucker J. Management of Spontaneous Intracerebral Hemorrhage. Curr Neurol Neurosci Rep. 2017;17. Veltkamp R, Purrucker J. Management of Spontaneous Intracerebral Hemorrhage. Curr Neurol Neurosci Rep. 2017;17.
5.
go back to reference Gregson BA, Broderick JP, Auer LM, et al. Individual patient data subgroup meta-analysis of surgery for Spontaneous Supratentorial Intracerebral Haemorrhage. Stroke. 2012;43:1496.CrossRefPubMedPubMedCentral Gregson BA, Broderick JP, Auer LM, et al. Individual patient data subgroup meta-analysis of surgery for Spontaneous Supratentorial Intracerebral Haemorrhage. Stroke. 2012;43:1496.CrossRefPubMedPubMedCentral
6.
go back to reference Mendelow AD, Gregson BA, Fernandes HM, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet. 2005;365:387–97.CrossRefPubMed Mendelow AD, Gregson BA, Fernandes HM, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet. 2005;365:387–97.CrossRefPubMed
7.
go back to reference Vidale S, Bellocchi S, Taborelli A. Surgery for cerebral haemor-rhage—STICH II trial. Lancet. 2013;382:1401–2.CrossRefPubMed Vidale S, Bellocchi S, Taborelli A. Surgery for cerebral haemor-rhage—STICH II trial. Lancet. 2013;382:1401–2.CrossRefPubMed
8.
go back to reference Fiorella D, Arthur AS, Mocco JD. 305 The INVEST Trial. Neurosurgery. 63:187. 2016. Fiorella D, Arthur AS, Mocco JD. 305 The INVEST Trial. Neurosurgery. 63:187. 2016.
9.
go back to reference Hanley DF, Thompson RE, Muschelli J, et al. Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial. Lancet Neurol. 2016;15:1228–37.CrossRefPubMedPubMedCentral Hanley DF, Thompson RE, Muschelli J, et al. Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial. Lancet Neurol. 2016;15:1228–37.CrossRefPubMedPubMedCentral
10.
go back to reference Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2022;53:282–361.CrossRef Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2022;53:282–361.CrossRef
11.
go back to reference Haider SP, Qureshi AI, Jain A, et al. Admission computed tomography radiomic signatures outperform hematoma volume in predicting baseline clinical severity and functional outcome in the ATACH-2 trial intracerebral hemorrhage population. Eur J Neurol. 2021;28:2989–3000.CrossRefPubMedPubMedCentral Haider SP, Qureshi AI, Jain A, et al. Admission computed tomography radiomic signatures outperform hematoma volume in predicting baseline clinical severity and functional outcome in the ATACH-2 trial intracerebral hemorrhage population. Eur J Neurol. 2021;28:2989–3000.CrossRefPubMedPubMedCentral
12.
go back to reference Chen Q, Zhu D, Liu J, et al. Clinical-radiomics Nomogram for Risk Estimation of Early Hematoma Expansion after Acute Intracerebral Hemorrhage. Acad Radiol. 2021;28:307–17.CrossRefPubMed Chen Q, Zhu D, Liu J, et al. Clinical-radiomics Nomogram for Risk Estimation of Early Hematoma Expansion after Acute Intracerebral Hemorrhage. Acad Radiol. 2021;28:307–17.CrossRefPubMed
13.
go back to reference Zhan C, Chen Q, Zhang M, et al. Radiomics for intracerebral hemorrhage: are all small hematomas benign? Br J Radiol. 2021;94. Zhan C, Chen Q, Zhang M, et al. Radiomics for intracerebral hemorrhage: are all small hematomas benign? Br J Radiol. 2021;94.
14.
go back to reference Gadelmawla ES. A vision system for surface roughness characterization using the gray level co-occurrence matrix. NDT E Int. 2004;37:577–88.CrossRef Gadelmawla ES. A vision system for surface roughness characterization using the gray level co-occurrence matrix. NDT E Int. 2004;37:577–88.CrossRef
15.
go back to reference Kliś KM, Krzyżewski RM, Kwinta BM, Stachura K, Gąsowski J. Computer-Assisted Analysis of Intracerebral Hemorrhage Shape and Density. World Neurosurg. 2018;120:e863–9.CrossRefPubMed Kliś KM, Krzyżewski RM, Kwinta BM, Stachura K, Gąsowski J. Computer-Assisted Analysis of Intracerebral Hemorrhage Shape and Density. World Neurosurg. 2018;120:e863–9.CrossRefPubMed
16.
go back to reference Shen Q, Shan Y, Hu Z, et al. Quantitative parameters of CT texture analysis as potential markersfor early prediction of spontaneous intracranial hemorrhage enlargement. Eur Radiol. 2018;28:4389–96.CrossRefPubMed Shen Q, Shan Y, Hu Z, et al. Quantitative parameters of CT texture analysis as potential markersfor early prediction of spontaneous intracranial hemorrhage enlargement. Eur Radiol. 2018;28:4389–96.CrossRefPubMed
17.
go back to reference Panchal HN, Shah MS, Shah DS. Intracerebral Hemorrhage Score and Volume as an Independent Predictor of Mortality in Primary Intracerebral Hemorrhage Patients. Indian J Surg. 2015;77:302.CrossRefPubMed Panchal HN, Shah MS, Shah DS. Intracerebral Hemorrhage Score and Volume as an Independent Predictor of Mortality in Primary Intracerebral Hemorrhage Patients. Indian J Surg. 2015;77:302.CrossRefPubMed
18.
go back to reference De Oliveira MAL. Surgery for spontaneous intracerebral hemorrhage. Crit Care. 2020;24. De Oliveira MAL. Surgery for spontaneous intracerebral hemorrhage. Crit Care. 2020;24.
19.
go back to reference Lv XN, Li Q. Imaging predictors for hematoma expansion in patients with intracerebral hemorrhage: A current review. Brain Hemorrhages. 2020;1:133–9.CrossRef Lv XN, Li Q. Imaging predictors for hematoma expansion in patients with intracerebral hemorrhage: A current review. Brain Hemorrhages. 2020;1:133–9.CrossRef
20.
go back to reference Chen CJ, Ding D, Ironside N, et al. Predictors of Surgical Intervention in Patients with Spontaneous Intracerebral Hemorrhage. World Neurosurg. 2019;123:e700.CrossRefPubMedPubMedCentral Chen CJ, Ding D, Ironside N, et al. Predictors of Surgical Intervention in Patients with Spontaneous Intracerebral Hemorrhage. World Neurosurg. 2019;123:e700.CrossRefPubMedPubMedCentral
21.
go back to reference Wang WZ, Jiang B, Liu HM, et al. Minimally invasive craniopuncture therapy vs. conservative treatment for spontaneous intracerebral hemorrhage: results from a randomized clinical trial in China. Int J Stroke. 2009;4:11–6.CrossRefPubMed Wang WZ, Jiang B, Liu HM, et al. Minimally invasive craniopuncture therapy vs. conservative treatment for spontaneous intracerebral hemorrhage: results from a randomized clinical trial in China. Int J Stroke. 2009;4:11–6.CrossRefPubMed
22.
go back to reference Al-Mufti F, Thabet AM, Singh T, El-Ghanem M, Amuluru K, Gandhi CD. Clinical and Radiographic Predictors of Intracerebral Hemorrhage Outcome. Interv Neurol. 2018;7:118.CrossRefPubMedPubMedCentral Al-Mufti F, Thabet AM, Singh T, El-Ghanem M, Amuluru K, Gandhi CD. Clinical and Radiographic Predictors of Intracerebral Hemorrhage Outcome. Interv Neurol. 2018;7:118.CrossRefPubMedPubMedCentral
Metadata
Title
Association of Imaging-based Predictors with Outcome in Different Treatment Options for Intracerebral Hemorrhage
Authors
Roger M. Krzyżewski
Borys M. Kwinta
Krzysztof Stachura
Tadeusz J. Popiela
Roman Pułyk
Agnieszka Słowik
Jerzy Gąsowski
Kornelia M. Kliś
Publication date
26-04-2024
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-024-01406-2