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Discrimination of Tumorous Intracerebral Hemorrhage from Benign Causes Using CT Densitometry

Authors
 Y.S. Choi  ;  T.H. Rim  ;  S.S. Ahn  ;  S.-K. Lee 
Citation
 American Journal of Neuroradiology, Vol.36(5) : 886-892, 2015 
Journal Title
 American Journal of Neuroradiology 
ISSN
 0195-6108 
Issue Date
2015
Abstract
BACKGROUND AND PURPOSE: Differentiation of tumorous intracerebral hemorrhage from benign etiology is critical in initial treatment plan and prognosis. Our aim was to investigate the diagnostic value of CT densitometry to discriminate tumorous and nontumorous causes of acute intracerebral hemorrhage. MATERIALS AND METHODS: This retrospective study included 110 patients with acute intracerebral hemorrhage classified into 5 groups: primary intracerebral hemorrhage without (group 1) or with antithrombotics (group 2) and secondary intracerebral hemorrhage with vascular malformation (group 3), brain metastases (group 4), or primary brain tumors (group 5). The 5 groups were dichotomized into tumorous (groups 4 and 5) and nontumorous intracerebral hemorrhage (groups 1-3). Histogram parameters of hematoma attenuation on nonenhanced CT were compared among the groups and between tumorous and nontumorous intracerebral hemorrhages. With receiver operating characteristic analysis, optimal cutoffs and area under the curve were calculated for discriminating tumorous and nontumorous intracerebral hemorrhages. RESULTS: Histogram analysis of acute intracerebral hemorrhage attenuation showed that group 1 had higher mean, 5th, 25th, 50th, and 75th percentile values than groups 4 and 5 and higher minimum and 5th percentile values than group 2. Group 3 had higher 5th percentile values than groups 4 and 5. After dichotomization, all histogram parameters except maximum and kurtosis were different between tumorous and nontumorous intracerebral hemorrhages, with tumors having lower cumulative histogram parameters and positive skewness. In receiver operating characteristic analysis, 5th and 25th percentile values showed the highest diagnostic performance for discriminating tumorous and nontumorous intracerebral hemorrhages, with 0.81 area under the curve, cutoffs of 34 HU and 44 HU, sensitivities of 65.6% and 70.0%, and specificities of 85.0% and 80.0%, respectively. CONCLUSIONS: CT densitometry of intracerebral hemorrhage on nonenhanced CT might be useful for discriminating tumorous and nontumorous causes of acute intracerebral hemorrhage.
Full Text
http://www.ajnr.org/content/36/5/886.long
DOI
10.3174/ajnr.A4233
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
안성수(Ahn, Sung Soo) ORCID logo https://orcid.org/0000-0002-0503-5558
이승구(Lee, Seung Koo) ORCID logo https://orcid.org/0000-0001-5646-4072
임형택(Rim, Tyler Hyungtaek)
최윤성(Choi, Yoon Seong)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140407
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