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

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.

Swirl sign score system: a novel and practical tool for predicting hematoma expansion risk after spontaneous intracerebral hemorrhage.

OBJECTIVE: To methodically analyze the swirl sign and construct a scoring system to predict the risk of hematoma expansion (HE) after spontaneous intracerebral hemorrhage (sICH). METHODS: We analysed 231 of 683 sICH patients with swirl signs on baseline noncontrast computed tomography (NCCT) images. The characteristics of the swirl sign were analyzed, including the number, maximum diameter, shape, boundary, minimum CT value of the swirl sign and the minimum distance from the swirl sign to the edge of the hematoma. In the development cohort, univariate and multivariate analyses were used to identify independent predictors of HE, and logistic regression analysis was used to construct the swirl sign score system. The swirl sign score system was verified in the validation cohort. RESULTS: The number and the minimum CT value of the swirl sign were independent predictors of HE. The swirl sign score system was constructed (2 points for the number of swirl signs > 1 and 1 point for the minimum CT value ≤ 41 Hounsfield units). The area under the curve of the swirl sign score system in predicting HE was 0.773 and 0.770 in the development and validation groups, respectively. CONCLUSIONS: The swirl sign score system is an easy-to-use radiological grading scale that requires only baseline NCCT images to effectively identify subjects at high risk of HE. ADVANCES IN KNOWLEDGE: Our newly developed semi-quantitative swirl sign score system greatly improves the ability of swirl sign to predict HE.

A novel clinical-radscore nomogram for predicting ruptured intracranial aneurysm.

Objectives: Our study aims to find the more practical and powerful method to predict intracranial aneurysm (IA) rupture through verification of predictive power of different models. Methods: Clinical and imaging data of 576 patients with IAs including 192 ruptured IAs and matched 384 unruptured IAs was retrospectively analyzed. Radiomics features derived from computed tomography angiography (CTA) images were selected by t-test and Elastic-Net regression. A radiomics score (radscore) was developed based on the optimal radiomics features. Inflammatory markers were selected by multivariate regression. And then 4 models including the radscore, inflammatory, clinical and clinical-radscore models (C-R model) were built. The receiver operating characteristic curve (ROC) was performed to evaluate the performance of each model, PHASES and ELAPSS. The nomogram visualizing the C-R model was constructed to predict the risk of IA rupture. Results: Five inflammatory features, 2 radiological characteristics and 7 radiomics features were significantly associated with IA rupture. The areas under ROCs of the radscore, inflammatory, clinical and C-R models were 0.814, 0.935, 0.970 and 0.975 in the training cohort and 0.805, 0.927, 0.952 and 0.962 in the validation cohort, respectively. Conclusion: The inflammatory model performs particularly well in predicting the risk of IA rupture, and its predictive power is further improved by combining with radiological and radiomics features and the C-R model performs the best. The C-R nomogram is a more stable and effective tool than PHASES and ELAPSS for individually predicting the risk of rupture for patients with IA.

Prediction of short-term prognosis of patients with hypertensive intracerebral hemorrhage by radiomic-clinical nomogram.

Hypertensive intracerebral hemorrhage (HICH) is the most common type of spontaneous intracerebral hemorrhage in China which is associated with high mortality and disability. We sought to develop and validate a noncontrast computed tomography (NCCT)-based nomogram model to achieve short-term prognostic prediction for patients with HICH. We retrospectively studied 292 patients with HICH from two medical centers, and they were divided into training (n = 151), validation (n = 66), and testing cohorts (n = 75). Based on radiomics, univariate and multivariate, and logistic regression analyses, four models (black hole sign, clinical, radiomics score, and combined models) were established to predict the prognosis of patients with HICH 30 days after the onset. The results suggested that the combined model had the best predictive performance with the area under the receiver operating characteristic curve (AUC) of 0.821, 0.816, and 0.815 in the training, validation, and testing cohorts, respectively. In addition, a radiomics-clinical (R-C) nomogram was visualized. A calibration curve analysis showed that the R-C nomogram had satisfactory calibration in the three cohorts. A decision curve analysis demonstrated that the R-C nomogram was clinically valuable. Our results suggest that the R-C nomogram can accurately and reliably predict the short-term prognosis of patients with HICH and provide a useful evaluation for making individualized treatment plans.

Simultaneous spatial and temporal focusing optical vortex pulses for micromachining through optically transparent materials.

We introduce the optical vortex beam into simultaneous spatial and temporal focusing (SSTF) technique, and theoretically and experimentally demonstrate the local control of peak intensity distribution at the focus of a simultaneous spatiotemporally focused optical vortex (SSTF OV) beam. To avoid nonlinear self-focusing in the conventional focusing scheme, a spatiotemporally focused femtosecond laser vortex beam was employed to achieve doughnut-shaped ablation and high aspect ratio (∼28) microchannels on the back surface of 3 mm thick soda-lime glass and fused silica substrates.

Three-Dimensional Laser Printing of Macro-Scale Glass Objects at a Micro-Scale Resolution.

Three-dimensional (3D) printing has allowed for the production of geometrically complex 3D objects with extreme flexibility, which is currently undergoing rapid expansion in terms of materials, functionalities, as well as areas of application. When attempting to print 3D microstructures in glass, femtosecond laser-induced chemical etching (FLICE)-which is a subtractive 3D printing technique-has proved itself a powerful approach. Here, we demonstrate the fabrication of macro-scale 3D glass objects of large heights up to ~3.8 cm with an identical lateral and longitudinal feature size of ~20 µm. The remarkable accomplishment is achieved by revealing an unexplored regime in the interaction of ultrafast laser pulses with fused silica, which results in depth-insensitive focusing of the laser pulses inside fused silica.

Aberration-insensitive three-dimensional micromachining in glass with spatiotemporally shaped femtosecond laser pulses.

We observe that focusing a femtosecond laser beam simultaneously chirped in time and space domains in glass can efficiently suppress the optical aberration caused by the refractive index mismatch at the interface of air and the glass sample. We then demonstrate three-dimensional microprocessing in glass with a nearly invariant spatial resolution for a large range of penetration depth between 250 µm and 9 mm without any aberration correction.

Tailoring femtosecond 1.5-µm Bessel beams for manufacturing high-aspect-ratio through-silicon vias.

Three-dimensional integrated circuits (3D ICs) are an attractive replacement for conventional 2D ICs as high-performance, low-power-consumption, and small-footprint microelectronic devices. However, one of the major remaining challenges is the manufacture of high-aspect-ratio through-silicon vias (TSVs), which is a crucial technology for the assembly of 3D Si ICs. Here, we present the fabrication of high-quality TSVs using a femtosecond (fs) 1.5-µm Bessel beam. To eliminate the severe ablation caused by the sidelobes of a conventional Bessel beam, a fs Bessel beam is tailored using a specially designed binary phase plate. We demonstrate that the tailored fs Bessel beam can be used to fabricate a 2D array of approximately ∅10-µm TSVs on a 100-µm-thick Si substrate without any sidelobe damage, suggesting potential application in the 3D assembly of 3D Si ICs.