Identification of Ischemic Stroke Stages in CT scan Brain Images Using Imagej Software

Rationale and Objectives: Ischemic strokes represent more than 80% of all stroke cases and are characterized by the occlusion of a blood vessel due to a thrombus or embolus. The temporal evolution of ischemic strokes occurs in four stages, i.e. Hyperacute, Acute, Subacute and Chronic. CT image by using ImageJ software help to identify stages of ischemic stroke in human brain as an alternative method in the CT diagnosis. Materials and Methods: Eighty samples of CT brain images were selected as research subjects in this study and confirmed examination by specialists in Department of Radiology at Saiful Anwar Public Hospital, Malang. Each CT scan brain image was analyzed using ImageJ version 1.48 software using standard Hounsfield unit. Results: The numerical values of gray scale for each stage of ischemic stroke stages have been identified using ImageJ software. They were as follows. The mean gray value level of normal cases was ≥ 29, of hyperacute was between 25 29, of acute cases was between 23 26, of subacute cases was between 20 23, and of chronic cases was ≤ 20. Conclusions: ImageJ is easy to use for identification of ischemic stroke stages in CT scan brain images. It has the ability to assess the density of each pixel and the density measurements have been calibrated to reflect the true Hounsfield unit values. The ratio of the accuracy of imageJ software in identification of ischemic stroke stages in CT scan brain images in this study was 90%.