The Hounsfield Unit of Perihematomal Edema Is Associated With Poor Clinical Outcomes in Intracerebral Hemorrhage

Abstract

Background: Hounsfield unit (HU) of perihematomal edema (PHE) may be a predictor of prognosis of intracerebral hemorrhage (ICH). Our study evaluated whether PHE mean HU at the 72 hours after ICH predicts outcome, and how it compares against other PHE measures.

Methods: Patients with ICH from a tertiary medical institution were included. PHE was segmented by the semiautomatic plane method to measure volume and mean HU. Outcomes of interest was poor 90-day prognosis (modified Rankin Scale score ≥3). Logistic regression was used to assess relationships with outcome.

Results: Data from a total of 159 patients with ICH were collected. The median mean HU of PHE at 72 hours was 22.1 (IQR: 19.2-25.0). Binary logistic regression showed that the 72-hour PHE mean HU was negatively correlated with the poor prognosis of patients with ICH (OR 0.59, 95% CI 0.47-0.75, P < 0.05). The receiver operator curves of meaningful indicators revealed that the area under the curve (AUC) of PHE mean HU at 72 hours was larger and the difference of AUC between PHE mean HU with PHE absolute volume or extension distance were statistically significant (P < 0.05). The 72-hour PHE mean HU has a higher value in predicting adverse prognosis of patients with ICH.

Conclusions: The PHE mean HU at 72 hours was negatively correlated with the poor prognosis of patients with ICH. The prediction ability of PHE mean HU at 72 hours was better than PHE absolute volume and extension distance, contributing to a rather good index for predicting outcome of ICH.

Keywords: Computed tomography; Functional outcome; Intracerebral hemorrhage; Perihematomal edema.