摘要
目的 分析基于CT平扫征象在自发性脑出血患者早期血肿扩大的预测价值.方法 回顾性分析我院2021年1月～2023年6月急性自发性脑出血患者169例,根据24h内复查CT结果分为血肿扩大组(n=55)和非扩大组(n=114).分析血肿的基线CT征象,并建立"密度异常组"、"形态异常组"及"联合征象组"3种征象组合,采用单因素分析及多因素Logistic回归分析筛选独立危险因素,采用ROC曲线评价各征象及征象组预测血肿扩大的价值.结果 每个病例收集了11个影像特征及3种组合特征,其中血肿初始体积及"混合征"、"黑洞征"、"漩涡征"、"岛征"、"密度异常组"、"联合征象组"的组间差异有统计学意义(P<0.05);多因素Logistic回归分析显示"密度异常组"、"联合征象组"为血肿扩大的独立预测因素(P=0.031);"混合征"、"漩涡征"中相对低密度区的体积及"岛征"中最大岛屿的最大径大者更易出现血肿扩大;血肿初始体积及"混合征"、"黑洞征"、"漩涡征"、"岛征"、"密度异常组"、"联合征象组"的曲线下面积分别为0.686、0.668、0.588、0.693、0.627、0.758、0.713.结论 CT平扫检查中,代表血肿密度异质性的"密度异常组"及代表密度、形态异常的"联合征象组"对脑出血患者早期血肿扩大有一定的预测价值.
Abstract
Objective To investigate the predictive value of non-contrast CT signs in early hematoma expansion in patients with spontaneous intracerebral hemorrhage.Methods A total of 169 cases of acute spontaneous cerebral hemorrhage in our hospital from January 2021 to June 2023 were analyzed retrospectively.According to the CT results within 24 h,and they were divided into hematoma expansion group(n=55)and non-expansion group(n=114).The baseline CT signs of the patients were analyzed,and three models of"density anomaly group","morphology abnormal group"and"combined signs group"were established.Independent risk factors were screened by univariate analysis and multivariate Logistic regression analysis,and the accuracy of each sign in predicting hematoma expansion was evaluated by ROC curve.Results Eleven imaging features and three combined features were collected for each case.Among them,the initial volume of hematoma,"mixed sign","black hole sign","swirl sign","island sign","density abnormality group"and"combined sign group"were statistically significant between two groups(P<0.05);multivariate logistic regression analysis showed that the"density abnormality group"and the"combined sign group"were independent predictors of hematoma expansion(P=0.031);haematoma expansion is more likely to occur when the volume of the relatively low density area in the"mixed sign"and"swirl sign"and the maximum diameter of the largest island in the"island sign"are large.The AUC of initial volume of the hematoma,"mixed sign","black hole sign","vortex sign"and"island sign","Density abnormality group"and the"combined sign group"were 0.686,0.668,0.588,0.693,0.627,0.758,0.713,respectively.Conclusion In non-contrast CT scan,the"density abnormality group"representing heterogeneity of hematoma density and the"combined sign group"representing density and morphology abnormalities have certain predictive value for early hematoma expansion in patients with cerebral hemorrhage.
基金项目
安徽省省级示范实验实训中心项目(2020sxzx21)
国家科技期刊平台
NSTL
万方数据