To provide a new method for predicting hematoma expansion in cerebral hemorrhage (ICH).

Initial CT scan images of 128 patients with spontaneous intracerebral hematoma were analyzed. Hematoma volumes were measured using the ABC/2 method and 3D Slicer. The difference of hematoma volume was calculated to predict hematoma expansion, and its predictive efficiency was compared with that of hematoma shape categories (hematoma expansion≥6.0 cm³ growth;≥12.5 cm³ growth).

The hematoma volume initially measured using the ABC/2 method and 3D Slicer was (21.4±16.4) cm³ and (17.7±14.0) cm³, respectively. The hematoma volume measured by the ABC/2 method was significantly larger than that using 3D Slicer (t=11.869, P<0.001). The volume of ICH hematoma measured by the ABC/2 method [(26.3±21.8) ml] at the second CT scan was significantly larger than that at the first scan [(21.4±16.4) ml, t=8.599, P<0.001]. The difference of ICH hematoma volume measured using the ABC/2 method and 3D Slicer was correlated with regular (r=0.628, P<0.05), irregular (r=0.603, P<0.05), and multiple lobular hematoma expansion (r=0.591, P<0.05). The areas under the curve of hematoma volume difference between ABC/2 and 3D Slicer at the first scan for predicting hematoma expansion ≥6.0 cm³ and ≥12.5 cm³ were both greater than those of hematoma shape category (0.866 vs 0.755, Z=2.496, P=0.013; 0.911 vs 0.731, Z=2.674, P=0.008).

Compared to hematoma shape category, the difference of hematoma volume measured using ABC/2 and 3D slicer could better predict the hematoma expansion.