Hematoma Expansion Within 24 Hours Of Intracerebral Hemorrhage And Its Association With Signs On Nonenhanced Computed Tomography

Objective:Intracerebral hemorrhage,the most devastating form of stroke,has high morbidity and mortality.Hematoma expansion is the most critical factors for the deterioration of neurological function and poor prognosis.Therefore,it is of great significance to look for indicators to predict HE.This paper analyzed cerebral hemorrhage patients in Nanshan people's hospital to explore the correlation between hematoma expansion within 24 hours of hypertensive intracerebral hemorrhage and signs of nonenhanced computed tomography(NECT).Methods:The clinical data and CT images of 185 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed.The difference in CT parameters were compared between the expansion group and the unexpanded group.Binary Logistic regression analysis was performed on the indicators with statistical significance between the two groups to identify the potential correlation between CT parameters and hematoma expansion.The roles of blend sign,lobulation sign,and black hole sign in predicting early hematoma expansion was assessed.Results:The CT quantitative data including initial volume,maximum diameter,minimum diameter,maximum CT value,mean CT value,maximum diameter and minimum diameter difference showed no significant difference between these two group(all P>0.05);CT qualitative data including the blend sign,lobulated sign,and black hole sign were significant difference(P<0.05),but the differences became not significant after the hematoma break into the ventricles.Binary Logistic regression analysis showed that blend signs,lobulation signs,and black hole signs were independent risk factors for early hematoma expansion,with sensitivity,specificity,positive predictive value and negative predictive value of the combined signs and the early hematoma expansion calculated by the fourfold-table method were 78.4%,59.0%,42.1%and 87.8%,respectively,and the Youden index was 0.374,Its Youden index was closer to 1 than the blend sign,the black hole sign,and the lobulation sign.Conclusion:The blend sign,the lobulation sign,and the black hole sign in NECT can be used to predict hematoma expansion within 24 hours after hypertensive cerebral hemorrhage.