Accuracy of imaging markers on noncontrast computed tomography in predicting intracerebral hemorrhage expansion

作者：Jinxiu Cai, Huachen Zhu, Dan Yang, Rong Yang, Xingquan Zhao, Jian Zhou, Peiyi Gao · 发表于：Neurological Research · 年份：2020 · DOI：10.1080/01616412.2020.1795577 · 被引用次数：20 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Neurosurgical Procedures and Complications、Acute Ischemic Stroke Management

Objectives Hematoma expansion (HE) is an important factor of unfavorable outcome in patients with intracerebral hemorrhage (ICH). Imaging markers on noncontrast computed tomography (NCCT) provide increasing value in the prediction of HE due to fast and easy-to-use advantages; however, the accuracy of NCCT-based prediction of intracerebral HE remains unclear. We aimed to investigate the predictive accuracy of NCCT markers for the evaluation of HE using a well-characterized ICH cohort. Methods We retrospectively analyzed 414 patients with spontaneous ICH, who underwent baseline CT within 6 h after symptom onset and follow-up CT within 24 h after ICH. Hematoma volumes were measured on baseline and follow-up CT images, and imaging features that predicted HE were analyzed. The test characteristics for the NCCT predictors were calculated. Results Of the 414 patients investigated, 63 presented blend sign, 45 showed black hole sign, 36 had island sign and 34 had swirl sign. In the 414 patients, 88 presented HE, the incidence was 21.26%. Of the 88 patients with HE, 22 presented blend sign, 11 showed black hole sign, 8 had swirl sign and 7 had island sign. The blend sign showed highest sensitivity (25.00%) and swirl sign showed the highest specificity (92.02%) among the four predictors. We noted excellent interobserver agreement for the identification of HE. Conclusion The four NCCT markers can predict HE with limited sensitivity, high specificity and good accuracy. This may be useful ...