Non-contrast CT For The Predictive Value Of Early Hematoma Enlargement In Patients With Intracerebral Hemorrhage

Objective:To investigate the value of hypodensities in hematoma、blend sign、island sign、black hole sign with non-contrast computed tomography for predicting hematoma enlargement in patients with intracerebral hemorrhage.Methods:Retrospective analysis of patients with intracerebral hemorrhage(ICH)diagnosed in the First Affiliated Hospital of Xiamen University from January 2015 to January 2019.Patients should meet the inclusion criteria and exclusion criteria and collect clinically relevant data in detail.Patients with cerebral hemorrhage were divided into hematoma enlargement(HE)group and Non-Hematoma Enlargement(NHE)group.Univariate and multivariate logistic regression analysis was performed on the clinical data of ICH patients to determine the independent predictors of early hematoma enlargement in patients with cerebral hemorrhage.The Receiver Operating Characteristic Curve(ROC)was used to compare the accuracy of non-contrast CT signs in the prediction of early hematoma enlargement in ICH.Results:Among the 194 patients with intracerebral hemorrhage,42 patients with hematoma enlargement(21.7%)and 152 patients with non-hematoma enlargement(78.3%).Among patients with intracerebral hemorrhage,40 cases(20.6%)had blend signs,23 cases(11.9%)had island signs,40 cases(20.6%)had the hypodensities in hematoma and 33 cases(17.0%)had black hole sign.There was a comparison between the hematoma enlargement group and the non-hematoma enlargement group.The difference between Glasgow Scale(GCS),Activated Partial Thromboplastin Time(APTT)、initial hematoma volume、blend signs、island sign、hypodensities in hematoma signs were statistically significant(P<0.05).Black hole sign is no difference between the two groups(P>0.05).Further multivariate logistic regression analysis showed that hypodensities in hematoma signs(OR=2.144;95%CI:1.003-4.581;P<0.05),blend sign(OR=3.182;95% CI: 1.382-7.328;P<0.05).Blend signs and hypodensities in hematoma signs were the independent risk factors for early hematoma enlargement in cerebral hemorrhage.The island sign and black hole sign are not related to the expansion of hematoma.After the analysis of the receiver operating characteristic curve,the area under the curve of blend signs,hypodensities in hematoma signs,blend signs and/or hypodensities in hematoma signs to predict the early hematoma enlargement of the cerebral hemorrhage were 0.642(95%CI:0.540-0.744;P<0.05)、0.630(95%CI:0.532-0.729;P<0.05)、0.697(95%CI:0.609-0.784;P<0.05)Conclusion:The blend sign and hypodensities in hematoma sign were independent predictors of early hematoma enlargement.The island sign and black hole sign are not related to the expansion of hematoma.The predictive value of blend signs and hypodensities in hematoma sign on hematoma enlargement is similar.Combining two signs does not improve predictive value.