摘要
目的探讨CT混合征和岛征及临床特点预测自发性脑出血(sICH)患者早期血肿扩大(HE)的价值。方法搜集本院sICH患者260例,根据是否存在HE分为HE组(65例)和非HE组(195例)。对两组患者入院时收缩压/舒张压、临床特点、入院格拉斯哥昏迷评分(GCS)、CT混合征及岛征等进行组间比较。采用多因素Logistic回归分析影响早期HE的危险因素;采用受试者工作特征曲线(ROC)分析影像学特征预测HE的价值。结果Logistic回归分析显示,高血压、入院收缩压、GCS评分、初始血肿量、合并破入脑室、混合征、岛征均为早期HE的危险因素(P<0.05);两名医生判读混合征及岛征的Kappa值分别为0.891和0.898,一致性较高。ROC分析显示混合征和岛征预测早期HE的敏感度、特异度、阳性预测值、阴性预测值和曲线下面积分别为38.5%、85.6%、47.2%、80.7%、0.621和33.9%、86.7%、45.8%、79.7%、0.603。结论高血压、入院收缩压、GCS评分、初始血肿量、合并脑室出血、CT混合征及岛征均为预测HE的影响因素;CT混合征和岛征均对HE有良好的预测价值。
Objective To investigate the value of blend sign and/or island sign with CT scanning and clinical features for predicting early hematoma enlargement(HE)in patients with spontaneous intracerebral hemorrhage(sICH).Methods 260 patients with sICH were retrospectively collected in our hospital and they were divided into HE group(65 cases)and non-HE group(195 cases)according to whether they had early HE or not.The general data of patients were collected and compared between the groups,including systolic/diastolic blood pressure,clinical features,Glasgow Coma Scale(GCS)at admission,blend sign and island sign on CT plain scan.Multivariate logistic regression analysis was performed on the factors influencing early HE.The predictive value of imaging signs of early HE was analyzed.Results Logistic regression analysis showed that history of hypertension,systolic blood pressure at admission,GCS score,initial hematoma volume,combined ventricular hemorrhage,blend sign and island sign were the independent risk factors for early HE(P<0.005).The consistency of interpretation of the blend sign and island sign by the two doctors were high,with the Kappa values of 0.891 and 0.898,respectively.The ROC curve analysis showed that the sensitivity,specificity,positive predictive value,negative predictive value,and area under the curve of blend sign and island sign in predicting early HE were 38.5%,85.6%,47.2%,80.7%,0.621 and 33.9%,86.7%,45.8%,79.7%,0.603,respectively.Conclusion Patients with sICH with a history of hypertension,systolic blood pressure at admission,GCS score,initial hematoma volume,combined ventricular hemorrhage,blend sign and island sign are predictive factors for HE.Both blend sign and island sign have good predictive value for HE.
作者
柳玥
蔡浩然
富彦
徐翯
刘恩虎
刘美洲
张雪宁
LIU Yue;CAI Haoran;FU Yan(Department of Radiology,The Second Affiliated Hospital of TianJin University,300211,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第11期2156-2160,共5页
Journal of Clinical Radiology
关键词
血肿扩大
体层摄影术
X线计算机
混合征
岛征
Hematoma enlargement
Tomography,X-ray computed
Blend sign
Island sign
