CT混杂征和漩涡征在脑出血血肿增大中的预测价值分析  

The predictive value of blend sign and swirl sign on CT for hematoma expansion of intracerebral hemorrhage

作　　者：黄秋菊 周胜利 马龙龙 吉廷举 周莹[2] HUANG Qiuju;ZHOU Shengli;MA Longlong;JI Tingju;ZHOU Ying(Department of Imaging,Guannan First People's Hospital of Lianyungang,Lianyungang 222500,China;Department of Imaging,Gaoxin Compus in The First People's Hospital of Lianyungang city,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市灌南县第一人民医院影像科,江苏连云港222500 [2]江苏省连云港市第一人民医院高新院区影像科,江苏连云港222000

出　　处：《医学影像学杂志》2024年第5期23-26,共4页Journal of Medical Imaging

摘　　要：目的 探讨CT混杂征、漩涡征与自发性脑出血(spontaneous intracerebral hemorrhage,SICH)早期血肿增大(hematoma expansion,HE)的相关性。方法 选取83例自发性脑出血患者,在6 h及24 h内行头颅CT检查,分为血肿增大组和血肿非增大组,比较两组的临床资料、入院时格拉斯哥(GCS)评分、影像学资料及受试者工作特征曲线评估自发性脑出血早期血肿增大的影响因素。结果 单因素组间分析显示两组在混杂征、漩涡征、联合征象、高血压、破入脑室、血肿体积和GCS评分差异有统计学意义(P<0.05)。Logistic线性回归分析显示混杂征、漩涡征、联合征象、高血压、破入脑室、血肿体积和GCS评分均是早期血肿增大的危险因素(P<0.05)。ROC曲线分析显示混杂征、漩涡征及联合征象预测自发性脑出血早期血肿增大的曲线下面积分别为0.699、0.720、0.825,混杂征、漩涡征及联合征象预测脑出血早期血肿增大的敏感度分别为70.0%、66.7%,80.0%,特异度分别为69.8%、77.4%、84.9%。结论 混杂征和漩涡征均可预测早期血肿增大,二者联合征象价值更高。Objective To investigate the correlation of CT blend signs,swirl signs for hematoma expansion(HE)in early spontaneous intracerebral hemorrhage(SICH).Methods 83 patients with SICH were divided into HE group and non-HE group after CT examination within 6 hours and 24 hours.The clinical data,glasgow coma scale(GCS),imaging data and the re⁃ceiver operating characteristic curve(ROC)of two groups were compared to evaluate the influence factors of early HE of SICH.Results Univariate between-group analysis showed a significant difference between the two groups in terms of blend sign,swirl sign,combined signs,hypertension,combined ventricular hemorrhage,hematoma volume and GCS score(P<0.05);Logistic regression analysis showed that blend sign,swirl sign,combined signs,hypertension,combined ventricular hemorrhage,hema⁃toma volume and GCS score were all independent risk factors for predicting HE(P<0.05);and The ROC curve analysis showed that the area under the curve of the blend sign,swirl sign and combined signs in predicting early spontaneous were 0.699,0.720 and 0.825.The sensitivity of blend sign,swirl sign and combined signs in predicting early spontaneous hemorrhage were 70.0%,66.7%and 80.0%.The specificity was 69.8%,77.4%and 84.9%,respectively.Conclusions Both blend sign and swirl sign predict early hematoma expansion and combined signs are more valuable.

关 键 词：自发性脑出血 血肿增大 混杂征 漩涡征 体层摄影术 X线计算机 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]