自发性脑出血CT影像学特征及其对早期血肿扩大的预测价值  

CT Imaging Features of Spontaneous Intracerebral Hemorrhage and its Value in Predicting Early Hematoma Enlargement

作　　者：顾腾辉 李立 高娟娟 钱伟军 GU Tenghui;LI Li;GAO Juanjuan(Department of Medical Imaging,Kaifeng Central Hospital,Kaifeng Henan 475000)

机构地区：[1]开封市中心医院医学影像科,河南开封475000 [2]新乡医学院附属开封市中心医院医学影像科,河南开封475000

出　　处：《医学临床研究》2025年第1期20-22,26,共4页Journal of Clinical Research

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20191179)。

摘　　要：【目的】探讨自发性脑出血的CT影像学特征及其对早期血肿扩大的预测价值。【方法】选取2023年2月至2024年2月在两院经头颅CT确诊的42例自发性脑出血患者,根据患者早期血肿变化分为血肿扩大组(n=28)和血肿未扩大组(n=14),分析自发性脑出血的影像学特征及自发性脑出血患者发生早期血肿扩大的影响因素。【结果】血肿扩大组患者岛征与混合征同时存在的检出率明显高于血肿未扩大组(P<0.05)。Logistic回归分析显示:岛征、混合征、岛征与混合征同时存在均是自发性脑出血患者发生早期血肿扩大的独立预测因素(P<0.05)。岛征预测早期血肿扩大的敏感性为53.57%,特异性为85.71%;混合征预测早期血肿扩大的敏感性和特异性均为85.71%;岛征与混合征同时存在预测早期血肿扩大敏感性为89.29%,特异性为92.86%。岛征与混合征同时存在预测早期血肿扩大的敏感性和特异性均高于岛征和混合征的敏感性和特异性。【结论】岛征和混合征对自发性脑出血患者发生早期血肿扩大的预测价值较高,但岛征与混合征同时存在的预测价值更高,可为临床医生提供重要参考依据。【Objective】To investigate the CT imaging features of hematoma enlargement in early stage of spontaneous intracerebral hemorrhage and its value in predicting early hematoma enlargement.【Methods】Forty-two patients with spontaneous intracerebral hemorrhage diagnosed by head CT in two hospitals from February 2023 to February 2024 were selected and divided into expanded hematoma group(n=28)and unexpanded hematoma group(n=14)according to the changes of early hematoma.The imaging features of early expanded hematoma in patients with spontaneous intracerebral hemorrhage and the influencing factors of early expanded hematoma in patients with spontaneous intracerebral hemorrhage were analyzed.【Results】The detection rate of island sign and mixed sign in patients with enlarged hematoma was significantly higher than that in the group without enlarged hematoma(P<0.05).Logistic regression analysis showed that island sign,mixed sign,island sign and mixed sign were independent predictors of early hematoma enlargement in patients with spontaneous intracerebral hemorrhage(P<0.05).The sensitivity and specificity of island sign to predict early hematoma enlargement were 53.57%and 85.71%respectively.The sensitivity and specificity of mixed signs in predicting early hematoma enlargement were 85.71%.The sensitivity and specificity of island sign and mixed sign were 89.29%and 92.86%respectively.The sensitivity and specificity of both island sign and mixed sign were higher than those of island sign and mixed sign in predicting early hematoma enlargement.【Conclusion】The prediction value of island sign and mixed sign is higher for early hematoma enlargement in patients with spontaneous intracerebral hemorrhage,but the prediction value of island sign and mixed sign is higher,which can provide important reference for clinicians.

关 键 词：脑出血 体层摄影术 螺旋计算机 血肿 预测 

分 类 号：R743.34[医药卫生—神经病学与精神病学]