CTA点征对急性高血压脑出血患者血肿扩大的预测价值分析  

Analysis of the Application Value of CTA Spot Signs in Prediction of Hematoma Expansion in Patients with Acute Hypertensive ICH

作　　者：王淑英[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院放射线科,黑龙江齐齐哈尔161000

出　　处：《中国医疗设备》2015年第7期66-68,共3页China Medical Devices

摘　　要：目的探讨CTA（CT血管造影）点征对急性高血压脑出血患者血肿扩大的预测价值。方法选择2013年1月-2014年12月于我院进行检查的76例脑出血患者作为研究对象,患者于入院时进行CT平扫及CTA检查,治疗24 h后复查CT平扫。通过CTA点征预测脑出血血肿是否扩大,记录CTA点征评价脑出血血肿扩大的灵敏度、特异度、准确度、阳性预测值和阴性预测值,并对脑出血血肿体积及形态进行统计学分析。结果 CTA点征诊断血肿扩大的灵敏度为89.7%（26/29）,特异度为93.6%（44/47）,准确度为92.1%（70/76）,阳性预测值为89.7%（26/29）,阴性预测值为93.6%（44/47）。CTA点征阳性组与阴性组血肿体积的比较在初查和复查时均具有显著差异（t=5.338,P=0.002;t=7.019,P=0.000）。CTA点征阳性组血肿形态规则18例,不规则11例;CTA点征阴性组血肿形态规则42例,不规则5例,两组比较差异具有统计学意义（P〈0.05）。结论CTA点征对脑出血血肿体积扩大具有较高的预测价值,可以作为一个独立的预测指标。Objective To explore the application value of CTA（Computerized Tomography Angiography） spot signs in prediction of hematoma expansion in patients with acute hypertensive ICH（Intra-Cerebral Hemorrhage）. Methods Altogether 76 ICH patients who had been examined in the hospital between January 2013 to December 2014 were selected. All the patients underwent plain CT scanning and CTA when they were hospitalized; then were re-examined by plain CT scanning 24 hours after they were treated. CTA spot signs were utilized to predict hematoma expansion in patients with acute hypertensive ICH and record the sensitivity, specificity, accuracy, positive and negative prediction values. Additionally, the hematoma volume and morphology were analyzed statistically. Results With the deployment of CTA spot signs, the sensitivity, specificity, accuracy, positive and negative prediction values of hematoma expansion were 89.7%（26/29）, 93.6%（44/47）, 92.1%（70/76）, 89.7%（26/29） and 93.6%（44/47）. Statistically significant differences were seen in the hematoma volume between Positive Group and Negative Group of CTA spot signs during preliminary examinations and re-examinations（t=5.338, P=0.002; t=7.019, P=0.000）. In Positive Group of CTA spot signs, there were 18 cases with regular hematoma morphology and 11 cases with irregular hematoma morphology. While, in Negative Group, there were 42 cases with regular hematoma morphology and 5 cases with irregular hematoma morphology. Statistically significant differences existed between two groups（P〈0.05）. Conclusion CTA spot signs revealed high effectiveness in prediction of hematoma expansion in patients with ICH, which could be used as an independent predictor.

关 键 词：脑出血 血肿体积 CTA点征 急性高血压 

分 类 号：R544.1[医药卫生—心血管疾病] R814.43[医药卫生—内科学]