Korean Journal of Radiology

  • 제25권2호
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  • Pages.166-178
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  • 2024
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Combining Non-Contrast CT Signs With Onset-to-Imaging Time to Predict the Evolution of Intracerebral Hemorrhage

  • Lei Song (Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University) ;
  • Xiaoming Qiu (Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University) ;
  • Cun Zhang (Department of Radiology, The First Affiliated Hospital of University of Science and Technology of China) ;
  • Hang Zhou (Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science) ;
  • Wenmin Guo (Department of Radiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine) ;
  • Yu Ye (Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University) ;
  • Rujia Wang (Department of Radiology, Tangshan Gongren Hospital) ;
  • Hui Xiong (Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University) ;
  • Ji Zhang (Department of Clinical Laboratory, Xiangyang Central Haspital, Affiliated Hospital of Hubei University of Arts and Science) ;
  • Dongfang Tang (Department of Neurosurgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science) ;
  • Liwei Zou (Department of Radiology, The Second Affiliated Hospital of Anhui Medical University) ;
  • Longsheng Wang (Department of Radiology, The Second Affiliated Hospital of Anhui Medical University) ;
  • Yongqiang Yu (Department of Radiology, The First Affiliated Hospital of Anhui Medical University) ;
  • Tingting Guo (Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University)
  • 투고 : 2023.06.29
  • 심사 : 2023.11.19
  • 발행 : 2024.02.01
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초록

Objective: This study aimed to determine the predictive performance of non-contrast CT (NCCT) signs for hemorrhagic growth after intracerebral hemorrhage (ICH) when stratified by onset-to-imaging time (OIT). Materials and Methods: 1488 supratentorial ICH within 6 h of onset were consecutively recruited from six centers between January 2018 and August 2022. NCCT signs were classified according to density (hypodensities, swirl sign, black hole sign, blend sign, fluid level, and heterogeneous density) and shape (island sign, satellite sign, and irregular shape) features. Multivariable logistic regression was used to evaluate the association between NCCT signs and three types of hemorrhagic growth: hematoma expansion (HE), intraventricular hemorrhage growth (IVHG), and revised HE (RHE). The performance of the NCCT signs was evaluated using the positive predictive value (PPV) stratified by OIT. Results: Multivariable analysis showed that hypodensities were an independent predictor of HE (adjusted odds ratio [95% confidence interval] of 7.99 [4.87-13.40]), IVHG (3.64 [2.15-6.24]), and RHE (7.90 [4.93-12.90]). Similarly, OIT (for a 1-h increase) was an independent inverse predictor of HE (0.59 [0.52-0.66]), IVHG (0.72 [0.64-0.81]), and RHE (0.61 [0.54-0.67]). Blend and island signs were independently associated with HE and RHE (10.60 [7.36-15.30] and 10.10 [7.10-14.60], respectively, for the blend sign and 2.75 [1.64-4.67] and 2.62 [1.60-4.30], respectively, for the island sign). Hypodensities demonstrated low PPVs of 0.41 (110/269) or lower for IVHG when stratified by OIT. When OIT was ≤ 2 h, the PPVs of hypodensities, blend sign, and island sign for RHE were 0.80 (215/269), 0.90 (142/157), and 0.83 (103/124), respectively. Conclusion: Hypodensities, blend sign, and island sign were the best NCCT predictors of RHE when OIT was ≤ 2 h. NCCT signs may assist in earlier recognition of the risk of hemorrhagic growth and guide early intervention to prevent neurological deterioration resulting from hemorrhagic growth.

키워드

과제정보

We appreciate the statistical consultation and analyses of Cun Zhang, The First Affiliated Hospital of University of Science and Technology of China. We would also like to thank Editage (www.editage.cn) for English language editing.

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