Development and Validation of Intracranial Thrombus Segmentation on CT Angiography in Patients with Acute Ischemic Stroke

被引:21
|
作者
Santos, Emilie M. M. [1 ,2 ,3 ,4 ]
Marquering, Henk A. [3 ,4 ]
Berkhemer, Olvert A. [3 ]
van Zwam, Wim H. [5 ]
van der Lugt, Aad [1 ]
Majoie, Charles B. [3 ]
Niessen, Wiro J. [1 ,2 ,6 ]
机构
[1] Erasmus MC, Dept Radiol, Rotterdam, Netherlands
[2] Erasmus MC, Dept Med Informat, Rotterdam, Netherlands
[3] AMC, Dept Radiol, Amsterdam, Netherlands
[4] AMC, Dept Biomed Engn & Phys, Amsterdam, Netherlands
[5] Maastricht Univ, Med Ctr, Dept Radiol, Maastricht, Netherlands
[6] Delft Univ Technol, Fac Sci Appl, Delft, Netherlands
来源
PLOS ONE | 2014年 / 9卷 / 07期
关键词
MIDDLE CEREBRAL-ARTERY; RECANALIZATION; THROMBOLYSIS;
D O I
10.1371/journal.pone.0101985
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background and Purpose: Thrombus characterization is increasingly considered important in predicting treatment success for patients with acute ischemic stroke. The lack of intensity contrast between thrombus and surrounding tissue in CT images makes manual delineation a difficult and time consuming task. Our aim was to develop an automated method for thrombus measurement on CT angiography and validate it against manual delineation. Materials and Methods: Automated thrombus segmentation was achieved using image intensity and a vascular shape prior derived from the segmentation of the contralateral artery. In 53 patients with acute ischemic stroke due to proximal intracranial arterial occlusion, automated length and volume measurements were performed. Accuracy was assessed by comparison with inter-observer variation of manual delineations using intraclass correlation coefficients and Bland-Altman analyses. Results: The automated method successfully segmented the thrombus for all 53 patients. The intraclass correlation of automated and manual length and volume measurements were 0.89 and 0.84. Bland-Altman analyses yielded a bias (limits of agreement) of -0.4 (-8.8, 7.7) mm and 8 (-126, 141) mm(3) for length and volume, respectively. This was comparable to the best interobserver agreement, with an intraclass correlation coefficients of 0.90 and 0.85 and a bias (limits of agreement) of -0.1 (-11.2, 10.9) mm and -17 (-216, 185) mm(3). Conclusions: The method facilitates automated thrombus segmentation for accurate length and volume measurements, is relatively fast and requires minimal user input, while being insensitive to high hematocrit levels and vascular calcifications. Furthermore, it has the potential to assess thrombus characteristics of low-density thrombi.
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页数:8
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