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<p>Heterogeneous hematoma exhibiting a blend sign undergo dynamic changes associated with neurological injury. This study quantified hyperdense and hypodense regions of blend sign on serial non-contrast computed tomography (NCCT) using ITK-SNAP, calculated the mean hounsfield unit (HU) difference (dHU), and evaluated its prognostic value in 261 patients with intracerebral hemorrhage (ICH). All patients underwent baseline CT within 6&#xa0;h of symptom onset and follow-up CT within 24&#xa0;h. Logistic regression and ROC analysis showed that a higher dHU was independently associated with secondary neurological deterioration, 30-day mortality, and poor 3-month functional outcomes. A dHU &gt; 3.25 predicted poor prognosis with good specificity (AUC 0.707, <i>P</i> &lt; 0.001). These findings suggest that the dHU of heterogeneous hematoma based on serial CT scans is independently associated with poor outcomes after acute ICH.</p><p>Trial registration: <a href="https://ClinicalTrials.gov">https://ClinicalTrials.gov</a>, NCT05548530.</p>

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Quantification of hounsfield unit difference in heterogeneous hematoma predicts poor functional outcomes in acute intracerebral hemorrhage

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月26日

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  • Qian Wu,
  • Lei Huang,
  • Na Chen,
  • Siying Ren,
  • Fei Ye,
  • Xu Zhao,
  • Guofeng Wu,
  • Likun Wang

摘要

Heterogeneous hematoma exhibiting a blend sign undergo dynamic changes associated with neurological injury. This study quantified hyperdense and hypodense regions of blend sign on serial non-contrast computed tomography (NCCT) using ITK-SNAP, calculated the mean hounsfield unit (HU) difference (dHU), and evaluated its prognostic value in 261 patients with intracerebral hemorrhage (ICH). All patients underwent baseline CT within 6 h of symptom onset and follow-up CT within 24 h. Logistic regression and ROC analysis showed that a higher dHU was independently associated with secondary neurological deterioration, 30-day mortality, and poor 3-month functional outcomes. A dHU > 3.25 predicted poor prognosis with good specificity (AUC 0.707, P < 0.001). These findings suggest that the dHU of heterogeneous hematoma based on serial CT scans is independently associated with poor outcomes after acute ICH.

Trial registration: https://ClinicalTrials.gov, NCT05548530.