• Jeroen de Bresser, Koen L Vincken, Anne J Kaspers, Gabriel J E Rinkel, Max A Viergever, and Geert Jan Biessels.
• Image Sciences Institute, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands. J.deBresser@umcutrecht.nl
• Stroke. 2012 Oct 1; 43 (10): 2782-4.

Background And PurposeMRI can be used to assess structural damage to the brain after aneurysmal subarachnoid hemorrhage. We tuned, validated, and applied k-Nearest Neighbor-based segmentation to quantify cerebral volumes on MRI 6 months after aneurysmal subarachnoid hemorrhage.MethodsAfter tuning, the accuracy of k-Nearest Neighbor-based segmentation was assessed with manual segmentations. Next, supratentorial cerebral parenchymal, peripheral cerebrospinal fluid, and lateral ventricular volumes of 55 patients were compared with those of 25 age- and sex-matched control subjects and related to clinical outcome (modified Rankin Scale).Resultsk-Nearest Neighbor-based segmentation showed good agreement with manual segmentations. Compared with control subjects, patients had a larger lateral ventricular volume (difference: log-transformed values 0.54; 95% CI,0.33-0.75), smaller peripheral cerebrospinal fluid volume (-26 mL; 95% CI, -40 to -11), and similar cerebral parenchymal volume (2 mL; 95% CI, -10 to 15). In patients, parenchymal (median split; OR, 38.8; 95% CI, 4.6-329.0) and ventricular volumes (7.4; 95% CI, 1.6-33.5) correlated with functional outcome.Conclusionsk-Nearest Neighbor-based segmentation provides accurate cerebral volume measurements after aneurysmal subarachnoid hemorrhage. In this proof-of-principle study of this volumetric technique, we demonstrated volume changes relative to controls, which correlated with functional outcome.

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