The relationship between perihematomal edema and hematoma expansion in acute spontaneous intracerebral hemorrhage: an exploratory radiomics analysis study

Zhiming Zhou; Xiaojia Wu; Yuanyuan Chen; Yuanxin Tan; Yu Zhou; Tianxing Huang; Hongli Zhou; Qi Lai; Dajing Guo

doi:10.3389/fnins.2024.1394795

The relationship between perihematomal edema and hematoma expansion in acute spontaneous intracerebral hemorrhage: an exploratory radiomics analysis study

Front Neurosci. 2024 Apr 30:18:1394795. doi: 10.3389/fnins.2024.1394795. eCollection 2024.

Authors

Zhiming Zhou^{1

2}, Xiaojia Wu^{1

2}, Yuanyuan Chen^{1

2}, Yuanxin Tan³, Yu Zhou^{1

2}, Tianxing Huang^{1

2}, Hongli Zhou⁴, Qi Lai^{1

2}, Dajing Guo^{1

2}

Affiliations

¹ Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
² Chongqing Medical Imaging Artificial Intelligence Lab, Chongqing, China.
³ Department of Radiology, Fifth People's Hospital of Chongqing, Chongqing, China.
⁴ Department of Radiology, Nanchong Central Hospital, Nanchong, Sichuan, China.

Abstract

Background: The relationship between early perihematomal edema (PHE) and hematoma expansion (HE) is unclear. We investigated this relationship in patients with acute spontaneous intracerebral hemorrhage (ICH), using radiomics.

Methods: In this multicenter retrospective study, we analyzed 490 patients with spontaneous ICH who underwent non-contrast computed tomography within 6 h of symptom onset, with follow-up imaging at 24 h. We performed HE and PHE image segmentation, and feature extraction and selection to identify HE-associated optimal radiomics features. We calculated radiomics scores of hematoma (Radscores_HEA) and PHE (Radscores_PHE) and constructed a combined model (Radscore_HEA_PHE). Relationships of the PHE radiomics features or Radscores_PHE with clinical variables, hematoma imaging signs, Radscores_HEA, and HE were assessed by univariate, correlation, and multivariate analyses. We compared predictive performances in the training (n = 296) and validation (n = 194) cohorts.

Results: Shape_VoxelVolume and Shape_MinorAxisLength of PHE were identified as optimal radiomics features associated with HE. Radscore_PHE (odds ratio = 1.039, p = 0.032) was an independent HE risk factor after adjusting for the ICH onset time, Glasgow Coma Scale score, baseline hematoma volume, hematoma shape, hematoma density, midline shift, and Radscore_HEA. The areas under the receiver operating characteristic curve of Radscore_PHE in the training and validation cohorts were 0.808 and 0.739, respectively. After incorporating Radscore_PHE, the integrated discrimination improvements of Radscore_HEA_PHE in the training and validation cohorts were 0.009 (p = 0.086) and -0.011 (p < 0.001), respectively.

Conclusion: Radscore_PHE, based on Shape_VoxelVolume and Shape_MinorAxisLength of PHE, independently predicts HE, while Radscore_PHE did not add significant incremental value to Radscore_HEA.

Keywords: Radiomics; computed tomography; hematoma expansion; intracerebral hemorrhage; perihematomal edema.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Natural Science Foundation of Chongqing, China (grant no. CSTB2022NSCQ-MSX0116) and the Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University (CQYC2020030389, 2020-7).