ABC/2
ABC/2, also confusingly written as 1/2ABC in some literature, is a fast and simple method for estimating the volume of intracerebral hemorrhage (or any other ellipsoid lesion for that matter) which does not require volumetric 3D analysis or software.
Intracerebral hemorrhage volume is an important predictor of morbidity and mortality (and thus trial eligibility) which is often underreported ^{1}. ABC/2 has been wellvalidated and correlates highly with volumes calculated by planimetric techniques, although does tend to overestimate ^{2,3,7}.
On this page:
Formula
First described by Kwak et al. ^{4 }and popularized by Kothari et al. ^{2}:
 A x B x C / 2
 A = greatest hemorrhage diameter in the axial plane
 B = hemorrhage diameter at 90º to A in the axial plane
 C = originally described as the number of CT slices with hemorrhage multiplied by the slice thickness, but can simply be substituted with the craniocaudal diameter of the hemorrhage where there is access to multiplanar reformats ^{1}
 this dimension is known as height (H) in other formulas
If the measurements are made in centimeters (cm), then the volume will be in cubic centimeters (cm^{3}) or milliliters (mL). The volume does tend to overestimate the true volume, with errors increasing in more irregularlyshaped and larger hemorrhages ^{7}.
Mathematical basis
The above formula is a simplified version of the formula for the volume of an ellipsoid, which is:
 4/3 π x (A/2) x (B/2) x (C/2)
 where A, B and C are the three diameters of the ellipsoid as defined above
If π is estimated as 3, then the formula can be simplified to ABC/2.
Interpretation
A baseline intracerebral hemorrhage volume of >5060 mL is a poor prognostic marker ^{1,5}.
Alternatives
In addition to the ABC/2 formula, there are other formulas which have been described and studied to estimate the volume of intracerebral hemorrhage ^{7}:
 formulas using A, B, and C (as defined above):
 ABCπ/6 (or π/6ABC): the precursor formula (Tada formula) to ABC/2 where π is estimated as 3 instead ^{7}
 ABC/3 (or 1/3ABC): was created to balance the overestimation of ABC/2, but tends to underestimate instead ^{7}
 2.5ABC/6 (or 2.5/6ABC): created to balance the overestimation of ABC/2 and the underestimation of ABC/3, has a greater accuracy than other formulas that use A, B, and C in one study ^{7}
 formulas using the hematoma area in the maximally involved slice (S) and height (H or C):
 SH/2 (or 1/2SH): derived from ABC/2 with the background theory that S will be slightly less than A x B, found to be the most accurate formula in one study (in comparison to other formulas including ABC/2) ^{7}
 SHπ/6 (or π/6SH): derived from ABCπ/6, and found to be the secondmost accurate formula in one study after SH/2 ^{7}
Practical points
There are some pitfalls with the ABC/2 method:
 assumes an ellipsoid lesion (and thus the more the lesion deviates from this morphology the more inaccurate the calculated volume will be)
 overestimates oral anticoagulantrelated intracerebral hemorrhage volumes (because they are often irregular in shape) ^{3}
To overcome these pitfalls, there are alternative formulas available which may have greater accuracy, such as SH/2 (or 1/2SH) and 2.5ABC/6 (or 2.5/6ABC) ^{7}.
Related Radiopaedia articles
Stroke and intracranial haemorrhage

stroke and intracranial hemorrhage
 code stroke CT (an approach)

ischemic stroke
 general discussions
 scoring and classification systems
 signs
 by region
 hemispheric infarcts
 frontal lobe infarct
 parietal lobe infarct
 temporal lobe infarct
 occipital lobe infarct
 alexia without agraphia syndrome: PCA
 cortical blindness syndrome (Anton syndrome): top of basilar or bilateral PCA
 Balint syndrome: bilateral PCA
 lacunar infarct

thalamic infarct
 DéjerineRoussy syndrome (thalamic pain syndrome): thalamoperforators of PCA
 top of the basilar syndrome
 striatocapsular infarct
 cerebellar infarct

brainstem infarct
 midbrain infarct
 Benedikt syndrome: PCA
 Claude syndrome: PCA
 Nothnagel syndrome: PCA
 Weber syndrome: PCA
 pontine infarct
 BrissaudSicard syndrome
 facial colliculus syndrome
 Gasperini syndrome: basilar artery or AICA
 inferior medial pontine syndrome (Foville syndrome): basilar artery
 lateral pontine syndrome (MarieFoix syndrome): basilar artery or AICA
 lockedin syndrome: basilar artery
 MillardGubler syndrome: basilar artery
 Raymond syndrome: basilar artery
 medullary infarct
 BabinskiNageotte syndrome
 hemimedullary syndrome (Reinhold syndrome)
 lateral medullary stroke syndrome (Wallenberg syndrome)
 medial medullary syndrome (Déjerine syndrome)
 Opalski syndrome
 midbrain infarct
 acute spinal cord ischemia syndrome
 hemispheric infarcts
 by vascular territory
 treatment options
 complications

intracranial hemorrhage

intraaxial hemorrhage
 signs and formulas
 ABC/2 (volume estimation)
 CTA spot sign
 swirl sign
 by region or type
 signs and formulas
 extraaxial hemorrhage

intraaxial hemorrhage