ABC/2 formula versus computer-assisted analysis in calculating intra-cranial haemorrhage volume on computed tomographic imaging

Abstract

Purpose Intra-cerebral hemorrhage is the most severe type of stroke, and hematoma volume is the strongest prognostic factor. Developing a cost and time-effective method to compute volumes of intracranial hemorrhage in patients of a high volume, tertiary center would assist in rapid triaging and minimizing treatment delays.Description The volumes of epidural, subdural and intra-parenchymal hemorrhages were calculated using ABC/2 method and compared with planimetric software method. ICH score was calculated and correlated with in-hospital mortality in non-traumatic cases.Results The median IQR volume of the ABC/2 formula method versus planimetric method, suggested no statistically significant difference (p - 0.079) in hematoma volume calculation. No statistically significant difference existed w.r.t degree of irregularity (p-0.849) and heterogeneity (p-0.815) of hemorrhage. Excellent agreement was found between the two methods while considering all 3 types of hemorrhages together (ICC - 0.969); however, discrepancies arose in case of extensive subdural hemorrhages (p- 0.041). ICH score was found to be directly proportional to mortality.Conclusion Overall, the ABC/2 formula and software-assisted methods performed equally well in estimating volumes of intraparenchymal and epidural hemorrhages; however, ABC/2 method overestimates the volume in extensive subdural hemorrhages. Intraventricular and infratentorial extensions were other parameters of the ICH score with relatively higher significance.

Keywords

• ABC/2 formula
• ICH score
• haemorrhage volume
• CT brain