| Purpose: 1/2ABC has been used widely for volume assessment of intracerebral hematoma.Its accuracy is affected by the shape and size of hematoma and is only suitable for calculating regular and small volume hematoma.However,the shape of hematoma is mostly irregular in clinic.Therefore,we took the hematoma volume measured by 3D Slicer as the reference standard,and re-explored the formula of hematoma volume in order to find a method that can calculate the volume of hematoma accurately,reliably and quickly.Methods: Computed tomographic image data of 257 patients with intracerebral hemorrhage were collected.Hematoma volumes were estimated by using 3D-Slicer and 7 formula methods(?/6ABC,1/2ABC,1/3ABC,2/3SH,1/2SH,?/6SH,2.5/6ABC).Taking the hematoma volume measured by 3D-Slicer as the reference standard,the overall accuracy and reliability of the seven formulas were evaluated.Then,according to the size,shape and location of hematoma,the accuracy of 7 formulas was analyzed again.At the same time,the time of calculating hematoma volume by 1/2SH,1/2ABC and 3D-Slicer was noted for further statistical analysis.Results: 1.The accuracy of the seven formula methods based on the error analysis from the highest to the lowest was: ?/6SH,1/2SH,2.5/6ABC,1/3ABC,1/2 ABC,?/6ABC or 2/3SH.According to the concordance analysis and the ROC curve analysis,the results were as follows: 1/2SH,?/6SH,2.5/6ABC,1/3ABC,1/2ABC,2/3SH,?/6ABC.Besides,after categorizing according to the size,shape and location of hematoma,in any subgroup,the accuracy of 1/2SH,?/6SH and 2.5/6ABC was almost higher than that of 1/3ABC,1/2ABC,2/3SH and ?/6ABC,and the accuracy of 1/2SH and ?/6SH was almost more than that of 2.5/6ABC.2.Intraclass correlation coefficients(ICC)of 1/2SH in intra-and interresearcher were 0.998(95% CI,0.998-0.999)and 0.989(95% CI,0.982-0.993),respectively.For the formula of ?/6SH,ICC were same as that of 1/2ABC.Kappa values of 1/2SH in intra-and inter-observer were 0.992(95% CI,0.976-1)and 0.913(95% CI,0.862-0.964),respectively.For ?/6SH,kappa values in within-and between-reader were 0.984(95%CI,0.882-0.926)and 0.904(95%CI,0.851-0.957),respectively.3.The average time taken to calculate hematoma volume by 1/2SH,1/2ABC and 3D Slicer was 74 seconds(38-114 seconds),61 seconds(43-93 seconds)and 6 minutes(2-16 minutes),respectively.Conclusions: 1.1/2SH or ?/6SH is an accurate,reliable and rapid method for calculating hematoma volume of intracerebral hemorrhage.The accuracy and reliability of 1/2SH are slightly higher than those of ?/6SH.2.2.5/6ABC is a more accurate method than 1/2ABC when it is not possible to obtain the maximum slice area(S)of hematoma in patients with intracerebral hemorrhage. |
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