期刊
JOURNAL OF THE AMERICAN HEART ASSOCIATION
卷 10, 期 3, 页码 -出版社
WILEY
DOI: 10.1161/JAHA.120.018248
关键词
active bleeding; computed tomography; hematoma expansion; Intracerebral hemorrhage; Intraventricular hemorrhage
资金
- National Key Research and Development Program of China [2018YFC1312200, 2018YFC1312203]
- China Association of Science and Technology Young Talent Project [2017QNRC001]
- Chongqing High-End Young Investigator Project [2019GDRC005]
The study revealed that NCCT markers are independently associated with IVH growth and RHE, with the expansion-prone hematoma showing higher predictive accuracy. These findings can aid in risk stratification based on NCCT markers for predicting active bleeding.
BACKGROUND: Noncontrast computed tomography (NCCT) markers are the emerging predictors of hematoma expansion in intracerebral hemorrhage. However, the relationship between NCCT markers and the dynamic change of hematoma in parenchymal tissues and the ventricular system remains unclear. METHODS AND RESULTS: We included 314 consecutive patients with intracerebral hemorrhage admitted to our hospital from July 2011 to May 2017. The intracerebral hemorrhage volumes and intraventricular hemorrhage (IVH) volumes were measured using a semiautomated, computer-assisted technique. Revised hematoma expansion (RHE) was defined by incorporating the original definition of hematoma expansion into IVH growth. Receiver operating characteristic curve analysis was used to compare the performance of the NCCT markers in predicting the IVH growth and RHE. Of 314 patients in our study, 61 (19.4%) had IVH growth and 93 (23.9%) had RHE. After adjustment for potential confounding variables, blend sign, black hole sign, island sign, and expansion-prone hematoma could independently predict IVH growth and RHE in the multivariate logistic regression analysis. Expansion-prone hematoma had a higher predictive performance of RHE than any single marker. The diagnostic accuracy of RHE in predicting poor prognosis was significantly higher than that of hematoma expansion. CONCLUSIONS: The NCCT markers are independently associated with IVH growth and RHE. Furthermore, the expansion-prone hematoma has a higher predictive accuracy for prediction of RHE and poor outcome than any single NCCT marker. These findings may assist in risk stratification of NCCT signs for predicting active bleeding.
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