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Updated: May 11, 2026

Automated Midline Shift and Intracranial Pressure Estimation based on Brain CT Images
Published on: April 13, 2013
The influence of image setting on intracranial translucency measurement by manual and semi-automated system
Li Zhen1, Xin Yang, Yuen Ha Ting
1Fetal Medicine Unit, Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Objective:
To investigate the agreement between manual and semi-automated system and the effect of different image settings on intracranial translucency (IT) measurement.
Methods:
A prospective study was conducted on 55 women carrying singleton pregnancy who attended first trimester Down syndrome screening. IT was measured both manually and by semi-automated system at the same default image setting. The IT measurements were then repeated with the post-processing changes in the image setting one at a time. The difference in IT measurements between the altered and the original images were assessed.
Results:
Intracranial translucency was successfully measured on 55 images both manually and by semi-automated method. There was strong agreement in IT measurements between the two methods with a mean difference (manual minus semi-automated) of 0.011 mm (95% confidence interval--0.052 mm-0.094 mm). There were statistically significant variations in both manual and semi-automated IT measurement after changing the Gain and the Contrast. The greatest changes occurred when the Contrast was reduced to 1 (IT reduced by 0.591 mm in semi-automated; 0.565 mm in manual), followed by when the Gain was increased to 15 (IT reduced by 0.424 mm in semi-automated; 0.524 mm in manual).
Conclusions:
The image settings may affect IT identification and measurement. Increased Gain and reduced Contrast are the most influential factors and may cause under-measurement of IT.

