Comparison of the Ellipsoid Methods and the Cavalieri Method, for Calculating Hematoma Volume in Computed Tomography by non-Specialist

Abstract

Objective: Intracerebral haemorrhages account for approximately 20% of all strokes and have higher morbidity and mortality, nearly 60% of patients die within a year, and 20% of the survivors live disabled. The volume of intracerebral haemorrhage has a strong association with the unfavourable outcome; therefore, fast and accurate measurement of the volume is crucial for clinical decision making. This study aimed to compare the ellipsoid methods and the Cavalieri method for calculating intracerebral hematoma volumes by physicians without special education on computed tomography assessment. Methods: The hematoma volumes in the computed tomography images of 30 consecutive patients were measured via ellipsoid methods and the Cavalieri method. The calculated volumes of hematoma by the four methods were compared statistically. Results: The median haematoma volumes (interquartile ranges) for ‘Cavalieri’, ‘prolate ellipse (abc)’, ‘prolate sphere (aac)’ and ‘sphere (aaa)’ methods were 23.2 (27.4), 37.2 (45.8), 22.1 (30.75), and 14.4 (31.87) respectively. A Friedman repeated measures ANOVA test determined that the results of the four methods to evaluate the haematoma volume differ significantly (p<0.001). A Durbin-Conover test demonstrated that the abc method was significantly different from other methods and that no significant difference among other methods was present. A week agreement was found between methods (Kendall’s W = 0.3). Conclusion: Apart from the ‘prolate ellipse (abc)’ method, which tends to over-calculate the volume, three methods out of four seem feasible to use for physicians without special education on computed tomography assessment.

Keywords

• Computed tomography
• intracerebral haemorrhage calculation
• volume

Bilgisayarlı Tomografide Hematom Hacminin Uzman Olmayanlar Tarafından Hesaplanması için Elipsoid Yöntemler ile Cavalieri Yönteminin Karşılaştırılması

Abstract

Amaç: İntraserebral kanamalar tüm inmelerin yaklaşık %20'sini oluşturur ve yüksek morbidite ile mortaliteye sahiptir, hastaların yaklaşık %60'ı bir yıl içinde ölür ve hayatta kalanların ise %20'si engelli yaşar. İntraserebral kanama hacminin olumsuz sonuç ile güçlü bir ilişkisi vardır; bu nedenle, hacmin hızlı ve doğru bir şekilde ölçülmesi klinik karar verme için çok önemlidir. Bu çalışmada bilgisayarlı tomografi değerlendirmesinde özel eğitim almamış hekimler tarafından intraserebral hematom hacimlerini hesaplamak için elipsoid yöntemlerle Cavalieri yönteminin karşılaştırılması amaçlanmıştır. Yöntem: Ardışık 30 hastanın bilgisayarlı tomografi görüntülerindeki hematom hacimleri elipsoid yöntemleri ve Cavalieri yöntemi ile ölçüldü. Dört yöntemle hesaplanan hematom hacimleri istatistiksel olarak karşılaştırıldı. Bulgular: 'Cavalieri', 'yayvan elips (abc)', 'yayvan küre (aac)' ve 'küre (aaa)' yöntemleri için medyan hematom hacimleri (çeyrekler arası aralık) sırasıyla 23,2 (27,4), 37,2 (45,8), 22,1 (30,75) ve 14,4 (31,87) idi. Friedman tekrarlanan ölçümler ANOVA testi, hematom hacmini değerlendirmek için dört yöntemin sonuçlarının önemli ölçüde farklı olduğunu belirledi (p<0.001). Durbin-Conover testi, abc yönteminin diğer yöntemlerden önemli ölçüde farklı olduğunu ve diğer yöntemler arasında anlamlı bir fark olmadığını gösterdi. Yöntemler arasında bir zayıf bir uzlaşma saptandı (Kendall’ın W = 0.3). Sonuç: Hacmi fazla hesaplama eğiliminde olan 'yayvan elips (abc)' yöntemi hariç tutulursa; bilgisayarlı tomografi değerlendirmesinde özel eğitim almamış doktorlar için dört yöntemden üçü kullanılabilir.

Keywords

• Bilgisayarlı tomografi
• intraserebral kanama hesaplama
• hacim

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