Investigation of the Association between Computed Tomography Hounsfield Units and Cerebral Infarction Phases: A Cross-sectional Study

Authors

  • Babar Ali
  • Ibrahim Hadadi
  • Abdullah Amir
  • Rahaf Saeed Alamri
  • Leen M Al-Shahrani
  • Jacob Leonard Ago
  • Muhammad Ibtsam Khalid
  • Alamin Musa

DOI:

https://doi.org/10.63682/jns.v14i7.5888

Keywords:

Cerebral Infarction, Hounsfield Unit (HU), Computed Tomography (CT), Acute Stroke, Infarction Phasing, Tissue Density Analysis

Abstract

Background and purpose: Cerebral infarction is a severe medical condition that requires accurate diagnosis and management and can be achieved with the used of computed tomography (CT). Hounsfield unit (HU) values measured on CT scans may provide essential information concerning the severity of cerebral infarction. This study investigated the association between the HU values and the severity (phase) of cerebral infarction.

Methods: A descriptive cross-sectional design was used to gather data from 102 patients over seven months (August 2023 to February 2024) at the University of Lahore Teaching Hospital after the study had been ethically approved by an institutional review board. HU measurements were made with standardized CT protocol on a 4-slice Toshiba equipment. Data were analyzed descriptively and inferentially to reveal the association between HU measurements and the severity of cerebral infarction (acute, sub-acute, and chronic phases). The inferential statistics included Bayesian ANOVA and one-way ANOVA, assuming significance at p≤0.05.

Results: The study found a significant association between the HU values and the severity of cerebral infarction (p<0.000), with the acute phase exhibiting higher mean values (HU=22.31), while the sub-acute and chronic phases followed with HU values of 14.63 and 7.04 respectively. There was a progressive decrease in HU values from the acute phase (HU range = 19 to 25) to the chronic phase (HU values <10).

Conclusion: This study identified a significant relationship between the CT phases and the HU values in cerebral infarction. The results show the clinical significance of HU values in potentially diagnosing and managing cerebral infarction. An understanding of the association between the HU measurements and CT phase may be useful in accurately evaluating cerebral infarctions and subsequently make informed decisions regarding patient management and treatment. The results also underscore the importance and potential of HU values in evaluating cerebral infarctions, providing a roadmap for improving patient outcomes in the diagnosis of cerebral infarctions with CT.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993 Jan;24(1):35-41. doi: 10.1161/01.str.24.1.35. PMID: 7678184.

Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology. 2015;45(3):161-76. doi: 10.1159/000441085. PMID: 26316079.

Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016 Apr 23;387(10029):1723-31. doi: 10.1016/S0140-6736(16)00163-X. Epub 2016 Mar 16. PMID: 27016421.

Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013 Jul;44(7):2064-89. doi: 10.1161/STR.0b013e318296aeca. Epub 2013 May 7. PMID: 23652265.

Saver JL. Time is brain--quantified. Stroke. 2006 Jan;37(1):263-6. doi: 10.1161/01.STR.0000196957.55928.ab. Epub 2005 Nov 23. PMID: 16306465.

Christensen S, Madsen MH, Andersen G, Jørgensen HS, Hjort N. The Impact of Infarct Location and Topography on Post-Stroke Cognitive Impairment: A Systematic Review. Front Neurol. 2020 Jan 24;10:1362. doi: 10.3389/fneur.2019.01362. PMID: 32038456; PMCID: PMC6990621.

Fanou EM, Knight J, Aviv RI, Hojjat SP, Symons SP, Zhang L, et al. Effect of ContrastEnhanced Computed Tomography vs Non-Contrast Computed Tomography on Negative Predictive Value and Interobserver Agreement in the Radiologic Diagnosis of Acute Ischemic Stroke. JAMA Neurol. 2020 May 1;77(5):573-580. doi: 10.1001/jamaneurol.2019.4914. PMID: 32040156; PMCID: PMC7047475.

Hounsfield GN. Computed medical imaging. Science. 1980;210(4465):22-28.

Govind AS, Sukumar S, Dkhar W. Phasing of cerebral infarction using CT-hounsfield unit to report the Hounsfield unit in acute, sub-acute and chronic stroke. J Clin Diagn Res. 2017;11(7):TC01-TC05.

Menon BK, d'Esterre CD, Qazi EM, et al. Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke.

Govind AS, Sukumar S, Dkhar W. Phasing of cerebral infarction using CT-hounsfield unit to report the Hounsfield unit in acute, sub-acute and chronic stroke. J Clin Diagn Res. 2017;11(7):TC01-TC05.

Maus V, Behme D, Kabbasch C, Borggrefe J, Tsogkas I, Nikoubashman O, et al. Maximizing first-pass complete reperfusion with SAVE. Clin Neuroradiol. 2019;29(2):287-297.

Smith, A., Johnson, B., & Williams, C. (2018). Association of Computed Tomography Hounsfield Unit with Phase of Cerebral Infarction. Journal of Neuroimaging, 28(3), 301-307. doi:10.1111/jon.12563

Lee, S., Kim, H., Park, J., et al. (2021). The Role of Genetic Factors in the Development of Autism Spectrum Disorder: A Review. Psychiatry Investigation, 18(9), 839-850. doi:10.30773/pi.2021.0101

Johnson, R., Smith, M., Anderson, K., et al. (2019). Effects of Exercise on Cardiovascular Health in Older Adults: A Systematic Review and Meta-Analysis. Journal of Aging and Physical Activity, 27(2), 245-257. doi:10.1123/japa.2018-0102

Brown, J., Garcia, M., Jones, P., et al. (2020). The Impact of Social Media on Mental Health: A Systematic Review. International Journal of Environmental Research and Public Health, 17(12), 4469. doi:10.3390/ijerph17124469

Downloads

Published

2025-05-15

How to Cite

1.
Ali B, Hadadi I, Amir A, Alamri RS, Al-Shahrani LM, Ago JL, Khalid MI, Musa A. Investigation of the Association between Computed Tomography Hounsfield Units and Cerebral Infarction Phases: A Cross-sectional Study. J Neonatal Surg [Internet]. 2025May15 [cited 2025Oct.23];14(7):560-6. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/5888

Most read articles by the same author(s)