RÉSUMÉ
Objective To explore the effect of head CT blend signs on short-term outcomes in patients with spontaneous supraten-torial intracerebral hemorrhage(ICH)after craniotomy.Methods A total of 435 patients with spontaneous supratentorial ICH who un-derwent craniotomy in the Department of Neurosurgery,Jinyang Hospital Affiliated to Guizhou Medical University from January 2019 to December 2022 were enrolled retrospectively.The patients were divided into the blend sign group(n=105)and control group(n=330)based on the CT features at admission.The general clinical data,imaging data,surgical data,complications and prognosis were collected and compared between the two groups.The outcome was assessed by the mRS(modified Rankin scale)at discharge.Multivariate Logistic regression model was used to analyze the independent correlation between CT blend sign and poor outcomes.Results During the follow-up period,there was no significant differences in the proportion of patients with poor outcomes between the two groups.The poor outcomes after craniotomy was independently correlated with age,smoking history,diabetes history and Glasgow coma scale(GCS)at admission,but not with blend signs.Conclusion Head CT blend signs on admission is not associated with the poor outcomes in patients with sponta-neous supratentorial ICH after craniotomy.
RÉSUMÉ
@#Objective To investigate the application value of CT mixed sign combined with serum LDL level to predict hematoma expansion in sICH.Methods The clinical data of 100 sICH patients admitted to the Emergency ICU Department of Chuzhou First People’s Hospital from January 2020 to January 2022 were retrospectively analyzed,and they were divided into hematoma expansion group (31 cases) and non-hematoma expansion group (69 cases).The differences in general data,laboratory and imaging indicators between the two groups were analyzed,the influencing factors of hematoma expansion were analyzed by multivariate Logistic regression,and the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of CT mixed sign combined with serum LDL water on hematoma expansion.Results Systolic blood pressure,APTT,GLU,first review of hematoma volume and proportion of mixed signs on CT scan were greater in the hematoma-expanded group than those in the non-hematoma-expanded group,and admission GCS score and serum LDL level were lower than in the non-hematoma-expanded group (P<0.05).Logistic regression analysis showed that systolic blood pressure,admission GCS score,APTT,LDL,first review of hematoma volume,and CT scan mixed sign were independent influencing factors for sICH hematoma enlargement (P<0.05).The ROC curve results showed that the area under the ROC curve (AUC) for predicting sICH hematoma enlargement by CT mixed sign and serum LDL were 0.757 and 0.752,respectively,which were smaller than the AUC for predicting sICH hematoma enlargement by the combination of both (0.899) (P<0.05).Conclusion Hematoma enlargement in patients with sICH is influenced by several factors,among which CT scan mixed sign and serum LDL are closely related to it,and the combined detection of both can improve the predictive value of hematoma enlargement in sICH to a certain extent.
RÉSUMÉ
Objective To investigate the value of blend sign and/or black hole sign with CT scanning for predicting early hematoma enlargement in patients with primary intracerebral hemorrhage.Methods From July 2011 to July 2016,244 consecutive patients with primary intracerebral hemorrhage in the First Affiliated Hospital of Chongqing Medical University were enrolled prospectively.From the onset to the first CT time were all ≤ 6 h.They were randomly divided into either an early hematoma enlargement group (n =82) or a non-hematoma enlargement group (n =162) according to whether they had early hematoma enlargement or not.The general data of patients were collected and compared between the groups,including previous history,clinical features,Glasgow coma scale (GCS) at admission,imaging features (black hole sign,blend sign and black hole sign and/or blend sign),etc.Multivariate logistic regression analysis was performed on the factors influencing early hematoma enlargement.The predictive value of imaging signs of early hematoma enlargement was analyzed.Results (1) In patients with early hematoma enlargement,there were 27 (32.9％) patients had black hole sign,33 (40.2％) had blend sign,and 50(61.0％) had blend sign and/or black hole sign.(2) The volume of hematoma according to 1 ml,the first CT time from onset to admission according to 1 h,and GCS on admission according to 1,the black hole sign and blend sign were included in the multivariate logistic regression analysis.The results showed that both the blend sign (OR,14.04,95％ CI 5.16-38.18) and the black hole sign (OR,5.69,95％ CI 2.12-15.30) were the independent risk factors for early hematoma enlargement (all P ＜ 0.01).After further adjustment,it showed that the blend sign and/or black hole sign were also the independent risk factors for early hematoma enlargement (OR,14.08,95％ CI 5.99-33.08,P ＜0.01).(3) After the analysis of the receiver operating characteristic curve,the sensitivity,specificity,positive predictive value,negative predictive value,and Youden Index of the blend sign and/or black hole sign of predicting early hematoma enlargement were 61.0％,90.1％,76.0％,82.0％,and 0.511,respectively.Its Youden Index was closer to 1 than the black hole sign (Youden Index:0.280) and the blend sign (Youden Index:0.346).Conclusion Compared with the single sign,the blend sign combined with black hole sign has better predictive ability for early hematoma enlargement after intracerebral hemorrhage.