Early Quantification of Hematoma Hounsfield Units on Noncontrast CT in Acute Intraventricular Hemorrhage Predicts Ventricular Clearance after Intraventricular Thrombolysis

J. Kornbluth; S. Nekoovaght-Tak; N. Ullman; J.R. Carhuapoma; D.F. Hanley; W. Ziai

doi:10.3174/ajnr.A4393

Article Figures & Data

Figures

Tables

Download figure
Open in new tab
Download powerpoint
Fig 1.
ROI mapping of IVH in a typical patient on days 1, 3, and 8.
Download figure
Open in new tab
Download powerpoint
Fig 2.
Change in total IVH HU counts with time in patients treated with rtPA.
Download figure
Open in new tab
Download powerpoint
Fig 3.
Change in IVH HU with time in patients treated with rtPA versus controls (n = 24).

Tables

Figures

View popup

Table 1:

Clinical and radiologic characteristics of patients treated with rtPA (N = 52)

	rtPA-Treated (N = 52)	P Value (Where Appropriate)
Clinical characteristics
Age (yr) (mean ± SEM)	55.6 ± 1.4
Male/female	34:18
Admission GCS (median) (IQR)	8.5 (9.0)
Radiographic characteristics
ICH location (%)
Basal ganglia	8 (15.4)
Caudate	2 (3.8)
Thalamus	25 (48.1)
Lobar	6 (11.5)
Primary IVH	11 (21.2)
Admission Graeb score²¹ (median) (IQR)	7 (3)
Total IVH volume (cm³) (median) (IQR)
t0	31.94 (34.1)
t1	12.84 (26.23)	.001 (t1 vs t0)^{^a}
t2	4.86 (14.49)	.001 (t2 vs t0)^{^a}
Total IVH HU counts (mean ± SEM)
t0	52.14 ± 0.59
t1	50.11 ± 0.63	.002 (t1 vs t0)^{^a}
t2	45.05 ± 0.71	.001 (t2 vs t0)^{^a}
Total CSF HU counts (mean ± SEM)
t0	12.37 ± 0.37
t1	11.77 ± 0.37	.18 (t1 vs t0)
t2	11.30 ± 0.33	.01 (t2 vs t0)^{^a}
Hematoma (ICH) volume (cm³) (median) (IQR)
t0	7.0 (10.11)
t1	5.35 (9.39)	.001 (t1 vs t0)^{^a}
t2	5.04 (8.06)	.001 (t2 vs t0)^{^a}
Hematoma (ICH) HU counts (mean ± SEM)
t0	55.06 ± 0.82
t1	54.78 ± 0.86	.74 (t1 vs t0)
t2	48.42 ± 0.84	.001 (t2 vs t0)^{^a}
Change in IVH volume (cm³) (median) (IQR)
Days 2–4 (t1–t0)	−15.36 (18.13)	.001^{^a}
Days 5–9 (t2–t0)	−17.72 (21.84)	.001^{^a}
Change in ICH volume (cm³) (median) (IQR)
Days 2–4 (t1–t0)	−1.59 (3.22)	.001^{^a}
Days 5–9 (t2–t0)	−1.66 (3.8)	.001^{^a}
Change in IVH HU counts (mean ± SEM)
Days 2–4 (t1–t0)	−2.03 ± 0.62	.002^{^a}
Days 5–9 (t2–t0)	−6.89 ± 0.74	.001^{^a}
Change in ICH HU counts (mean ± SEM)
Days 2–4 (t1–t0)	−0.28 ± 0.86	.74
Days 5–9 (t2–t0)	−6.65 ± 1.12	.001^{^a}

Note:—GCS indicates Glasgow Coma Scale.
↵a Significant.

View popup

Table 2:

Clinical and radiologic data for matched pairs

	rtPA-Treated (N = 12)	Control (N = 12)	P Value
Clinical characteristics
Age (yr) (mean ± SEM)	52.8 ± 2.0	57.5 ± 1.9	.21
Sex, male/female	11:1	7:5	.06
Admission GCS (median) (IQR)	8.5 (6)	5.5 (4.5)	.06
Radiographic characteristics
ICH location
Basal ganglia	2	3	.57
Caudate	3	1
Thalamus	7	8
Admission Graeb score (median) (IQR)	8 (1.5)	8 (4)	.19
Total IVH volume (cm³) (mean ± SEM)¹²
t0	26.0 ± 2.51	26.34 ± 3.24	.87
t1	13.56 ± 2.70	25.20 ± 3.73	.005^{^a}
t2	6.26 ± 1.36	18.63 ± 2.83	.002^{^a}
Total ventricular volume (cm³) (mean ± SEM)
t0	69.13 ± 5.85	84.11 ± 8.40	.18
t1	34.78 ± 4.96	56.57 ± 5.70	.01^{^a}
t2	24.80 ± 2.67	57.57 ± 10.32	.01^{^a}
Hematoma (ICH) volume (cm³) (mean ± SEM)
t0	12.93 ± 3.59	14.29 ± 3.23	.39
t1	14.21 ± 3.93	14.92 ± 2.97	.74
t2	11.17 ± 3.64	13.76 ± 3.19	.29
IVH HU counts (mean ± SEM)
t0	52.71 ± 1.18	52.05 ± 0.96	.70
t1	49.01 ± 0.98	50.42 ± 1.55	.35
t2	45.05 ± 1.24	49.48 ± 1.33	.02
ICH HU counts (mean ± SEM)
t0	56.24 ± 1.84	54.12 ± 1.17	.25
t1	55.79 ± 1.08	52.80 ± 1.08	.04^{^a}
t2	52.06 ± 1.28	52.56 ± 1.10	.77
Radiologic outcomes
Change in IVH volume (cm³) (median) (IQR)
Days 2–4 (t1–t0)	−10.88 (12.84)	−1.24 (2.78)	.002^{^a}
Days 5–9 (t2–t0)	−18.65 (14.88)	−6.85 (6.36)	.002^{^a}
Change in ICH volume (cm³) (median) (IQR)
Days 2–4 (t1–t0)	0.24 (1.91)	−.06 (2.99)	.88
Days 5–9 (t2–t0)	−1.98 (3.25)	−1.15 (2.33)	.27
Change in IVH HU counts (mean ± SEM)
Days 2–4 (t1–t0)	−3.70 ± 1.44	−1.63 ± 1.50	.07
Days 5–9 (t2–t0)	−7.66 ± 1.87	−2.58 ± 1.23	.02^{^a}
Change in ICH HU counts (mean ± SEM)
Days 2–4 (t1–t0)	−0.59 ± 1.55	−1.31 ± 1.51	.63
Days 5–9 (t2–t0)	−4.18 ± 2.23	−1.55 ± 1.39	.25