Decompressive craniectomy (DC) is a neurosurgical procedure performed to relieve the intracranial pressure engendered by brain swelling. However, no easy and accurate method exists for determining the craniectomy surface area. In this study, we implemented and compared three methods of estimating the craniectomy surface area for evaluating the decompressive effort. We collected 118 sets of preoperative and postoperative brain computed tomography images from patients who underwent craniectomy procedures between April 2009 and April 2011. The surface area associated with each craniectomy was estimated using the marching cube and quasi-Monte Carlo methods. The surface area was also estimated using a simple AC method, in which the area is calculated by multiplying the craniectomy length (A) by its height (C). The estimated surface area ranged from 9.46 to 205.32 cm2, with a median of 134.80 cm2. The root-mean-square deviation (RMSD) between the marching cube and quasi-Monte Carlo methods was 7.53 cm2. Furthermore, the RMSD was 14.45 cm2 between the marching cube and AC methods and 12.70 cm2 between the quasi-Monte Carlo and AC methods. Paired t-tests indicated no statistically significant difference between these methods. The marching cube and quasi-Monte Carlo methods yield similar results. The results calculated using the AC method are also clinically acceptable for estimating the DC surface area. Our results can facilitate additional studies on the association of decompressive effort with the effect of craniectomy.
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机译:减压颅骨切除术(DC)是一种神经外科手术,旨在缓解因脑肿胀而引起的颅内压。然而,不存在用于确定颅骨切除术表面积的简便且准确的方法。在这项研究中,我们实施并比较了三种评估颅骨切除术表面积的方法,以评估减压效果。我们从2009年4月至2011年4月之间接受了颅骨切除术的患者中收集了118套术前和术后的脑部X线断层扫描图像。使用行进立方体和准蒙特卡罗方法估算了与每次颅骨切除术相关的表面积。还使用简单的AC方法估算表面积,其中面积通过将颅骨切除术长度(A)乘以其高度(C)来计算。估计的表面积范围为9.46至205.32 cm 2 sup>,中位数为134.80 cm 2 sup>。行进立方体和准蒙特卡罗方法之间的均方根偏差(RMSD)为7.53 cm 2 sup>。此外,行进立方体法和交流法之间的RMSD为14.45 cm 2 sup>,准蒙特卡洛法和交流法之间的RMSD为12.70 cm 2 sup>。配对的t检验表明这些方法之间没有统计学上的显着差异。行进立方体和拟蒙特卡罗方法得出的结果相似。使用AC方法计算的结果在临床上也可以用于估计DC表面积。我们的结果可以促进有关减压努力与颅骨切除术效果相关性的其他研究。
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