Accuracy of imaging markers on noncontrast computed tomography in predicting intracerebral hemorrhage expansion
Autor: | Xingquan Zhao, Jian Zhou, Rong Yang, Dan Yang, Jinxiu Cai, Peiyi Gao, Huachen Zhu |
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Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Computed tomography Cohort Studies 03 medical and health sciences 0302 clinical medicine Hematoma Multidetector computed tomography medicine Humans In patient cardiovascular diseases Stroke Aged Cerebral Hemorrhage Retrospective Studies Intracerebral hemorrhage medicine.diagnostic_test business.industry Incidence General Medicine Middle Aged medicine.disease 030104 developmental biology Neurology Disease Progression Biomarker (medicine) Female Neurology (clinical) Radiology business Tomography X-Ray Computed 030217 neurology & neurosurgery Biomarkers |
Zdroj: | Neurological research. 42(11) |
ISSN: | 1743-1328 |
Popis: | 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 for prompt identification of patients at high risk of active bleeding, and prevention of over-treatment associated with HE. Abbreviations HE, hematoma expansion; ICH, intracerebral hemorrhage; NCCT, noncontrast computed tomography. |
Databáze: | OpenAIRE |
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