Predictive value of early hematoma expansion in patients with spontaneous cerebral hemorrhage based on non-contrast CT scan signs
ZHANG Hongwei
WANG Juanjuan
PEI Renming
ZHANG Junqin
LU Qifang
Abstract：Objective To investigate the predictive value of non-contrast CT signs in early hematoma expansion in patients with spontaneous intracerebral hemorrhage.Methods A total of 169 cases of acute spontaneous cerebral hemorrhage in our hospital from January 2021 to June 2023 were analyzed retrospectively.According to the CT results within 24 h,and they were divided into hematoma expansion group(n=55)and non-expansion group(n=114).The baseline CT signs of the patients were analyzed,and three models of"density anomaly group","morphology abnormal group"and"combined signs group"were established.Independent risk factors were screened by univariate analysis and multivariate Logistic regression analysis,and the accuracy of each sign in predicting hematoma expansion was evaluated by ROC curve.Results Eleven imaging features and three combined features were collected for each case.Among them,the initial volume of hematoma,"mixed sign","black hole sign","swirl sign","island sign","density abnormality group"and"combined sign group"were statistically significant between two groups(P<0.05);multivariate logistic regression analysis showed that the"density abnormality group"and the"combined sign group"were independent predictors of hematoma expansion(P=0.031);haematoma expansion is more likely to occur when the volume of the relatively low density area in the"mixed sign"and"swirl sign"and the maximum diameter of the largest island in the"island sign"are large.The AUC of initial volume of the hematoma,"mixed sign","black hole sign","vortex sign"and"island sign","Density abnormality group"and the"combined sign group"were 0.686,0.668,0.588,0.693,0.627,0.758,0.713,respectively.Conclusion In non-contrast CT scan,the"density abnormality group"representing heterogeneity of hematoma density and the"combined sign group"representing density and morphology abnormalities have certain predictive value for early hematoma expansion in patients with cerebral hemorrhage.
Keywords：spontaneous intracerebral hemorrhageCThematoma expansion
Publication Date：2024-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 820-825 )