Computer-Assisted Volumetric Measurement of Core Infarct Volume in Pediatric Patients: Feasibility for Clinical Use and Development of Quantitative Metrics for Outcome Prediction

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Fig 1.
A, Reduced diffusivity within the right putamen consistent with an area of acute infarction. B, The contour derived from the semiautomated computer segmentation software that is used to derive infarct volume.
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Fig 2.
Graphic representation of the correlation of core infarct volume and percentage brain infarction with the Pediatric Stroke Outcome Measure. TBV indicates total brain volume.
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Fig 3.
A and B, CAV segmentation results from patients in good and poor outcome groups, respectively. C and D, Manual segmentation results from the same respective patients.

Table 1:

Demographics of patients

Variable	No. (%)
Sex
Male	12 (52.2)
Female	11 (47.8)
Ethnicity (No., %)
White	4 (17.4)
Black	2 (8.7)
Asian	0 (0.0)
Hispanic	2 (8.7)
Other	15 (65.2)
Stroke risk factors (No., %)
No risk factors	5 (21.7)
Single risk factors	11 (47.8)
Multiple risk factors	7 (30.4)
Risk factor distribution^{^a} (No., %)
Hematologic	9 (39.1)
Vascular	7 (30.4)
Cardiac	4 (17.4)
Infection	3 (11.1)
Ingestion	1 (4.3)
Metabolic	1 (4.3)
Therapy (No., %)
Anticoagulation	4 (17.4)
Antiplatelet	9 (39.1)
Anticonvulsant	14 (60.9)
Surgery	3 (13.0)

Table 2:

Patient outcomes and stroke characteristics

Note:—ACA indicates anterior cerebral artery; PCA, posterior cerebral artery.
↵a “Good outcome” defined as healthy or mild disability using the Pediatric Stroke Outcome Measure.
↵b “Poor outcome” defined as moderate or severe disability using the Pediatric Stroke Outcome Measure or death.

Table 3:

Stroke characteristics and patient outcomes

Category	Mean	Range	95% Confidence Interval		Standard Error
Category	Mean	Range	Lower Limit	Upper Limit	Standard Error
Total brain volume (mL)	936.6	392.0–1387.0	815.7	1057.5	61.67
Stroke volume (mL)	60.9	0.1–229.0	31.7	90.0	14.88
Stroke volume (%)	8.2	0.1–48.4	3.6	12.9	2.35
Good outcome^{^a}
Stroke volume (mL)	7.4	0.08–31.63	0.97	26.12	5.48
Stroke volume (%)	0.6	0.01–2.64	0.05	2.12	0.45
Poor outcome^{^b}
Stroke volume (mL)	75.7	0.40–229.00	47.28	115.43	16.80
Stroke volume (%)	10.4	0.05–48.42	6.35	17.57	2.71

↵a “Good outcome” defined as healthy or mild disability using the Pediatric Stroke Outcome Measure.
↵b “Poor outcome” defined as moderate or severe disability using the Pediatric Stroke Outcome Measure or death.