CT黑洞征、卫星征、混合征对自发性脑出血早期血肿扩大的预测价值  

The Predictive Value of CT Black Hole Sign,Satellite Sign,and Mixed Sign for Spontaneous Intracerebral Hemorrhage Hematoma Enlargement

作　　者：吕洁 李沛 顾腾辉 LYU Jie;LI Pei;GU Tenghui(Department of Medical Imaging,Pingdingshan Traditional Chinese Medicine Hospital,Pingdingshan Henan 467000,China;Department of Medical Imaging,Kaifeng Central Hospital,Kaifeng Henan 475000,China)

机构地区：[1]平顶山市中医医院医学影像科,河南平顶山467000 [2]开封市中心医院医学影像科,河南开封475000

出　　处：《临床研究》2024年第4期33-36,共4页Clinical Research

基　　金：自发性幕上深部脑出血患者出血量临界值的相关研究(LHGJ20191179)。

摘　　要：目的分析CT黑洞征、卫星征、混合征对自发性脑出血血肿增大的预测价值。方法选取2021年7月至2023年11月收治的自发性脑出血患者60例,发病6 h内全部患者均完成基线CT扫描,并在首次扫描后24 h内进行CT扫描复查,根据血肿增大情况分为血肿增大组和无血肿增大组,对患者一般资料、影像资料等进行回顾性分析,通过多因素logistic回归模型对自发性脑出血早期血肿增大的影响因素进行分析;选择ROC曲线对曲线下面积(AUC)进行计算,对CT黑洞征、卫星征、混合征单独预测及三者联合预测自发性脑出血早期血肿增大的价值进行分析。结果60例自发性脑出血患者中,CT扫描复查结果发现,28例患者发生血肿增大(血肿增大组),早期血肿增大发生率为46.67%。单因素分析结果发现,血肿增大组的入院NIHSS评分高于无血肿增大组,入院血肿体积大于无血肿增大组,黑洞征例数、卫星征例数、混合征例数均多于无血肿增大组,比较差异有统计学意义(P<0.05)。多因素分析结果发现,预测早期血肿增大的独立影响因素包括黑洞征、卫星征及混合征(P<0.05)。在对自发性脑出血患者早期血肿增大进行预测时,黑洞征的AUC为0.659,卫星征的AUC为0.701,混合征的AUC为0.823,各征象联合的AUC为0.899,高于任一单一征象,差异有统计学意义(P<0.05)。结论CT黑洞征、卫星征、混合征是自发性脑出血患者早期血肿增大的典型影像学表现,通过CT黑洞征、卫星征及混合征能准确预测自发性脑出血患者早期血肿增大,各指征联合能提高预测的敏感性、特异性。Objective To analyze the predictive value of CT black hole sign,satellite sign,and mixed sign for spontaneous intracerebral hemorrhage hematoma enlargement.Methods A total of 60 patients with spontaneous cerebral hemorrhage were selected,all admitted to the hospital from July 2021 to November 2023.Within 6 hours of onset,all patients completed baseline CT scans and underwent CT scans within 24 hours of the first scan.According to the increase in hematoma,they were divided into two groups:the group with increased hematoma and the group without increased hematoma,Retrospective analysis of patient general information and imaging data was conducted,and analysis of the influencing factors of early hematoma enlargement in spontaneous cerebral hemorrhage using a multivariate logistic regression model.Select the ROC curve to calculate the area under the curve(AUC),and analyze the value of predicting CT black hole sign,satellite sign,and mixed sign separately,as well as the combination of the three in predicting early hematoma enlargement in spontaneous cerebral hemorrhage.Results Among all 60 patients with spontaneous cerebral hemorrhage,CT scan re examination results showed that 28 patients experienced hematoma enlargement(hematoma enlargement group),the incidence of early hematoma enlargement was 46.67%.The results of univariate analysis showed that the admission NIHSS score of the hematoma enlargement group was significantly higher than that of the non hematoma enlargement group,and the volume of admitted hematoma waslarger than that of the non hematoma enlargement group.The number of black hole sign,satellite sign,and mixed sign cases were higher than those of the non hematoma enlargement group,and the difference was statistically significant(P<0.05).The results of multivariate analysis showed that independent factors predicting early hematoma enlargement included black hole sign,satellite sign,and mixed sign(P<0.05).When predicting early hematoma enlargement in patients with spontaneous cerebral hemorrhage,the AUC o

关 键 词：CT扫描 黑洞征 卫星征 混合征 自发性脑出血 血肿增大 

分 类 号：R446.1[医药卫生—诊断学]