■现有的血肿扩大(HE)的放射学标志物显示出适度的预测准确性。我们旨在研究一种新的放射学标志物,该标志物将非对比CT(NCCT)和CT血管造影(CTA)的发现共同定位以预测HE。
■卡尔加里山麓医疗中心连续收治急性脑出血患者,加拿大,包括在内。黑色&白色标志被定义为与相应NCCT上的低密度标志共定位的CTA上的任何视觉识别的斑点标志。主要结果是血肿扩大(6mL或33%)。次要结果包括绝对(<3,3-6,6-12,12mL)和相对(0%,<25%,25%-50%,50%-75%,或>75%)血肿生长规模。
■包括200名患者,50(25%)经历他。44人(22%)显示了现场标志,69(34.5%)低密度征,和14个(7%)共同本地化,都是黑色和白色标志。那些带有黑色&白色标志的人的HE比例更高(100%对19.4%,p<0.001),绝对血肿增长较大(23.37mL(IQR=15.41-30.27)vs0mL(IQR=0-2.39),p<0.001)和相对血肿生长(120%(IQR=49-192)vs0%(0-15%),p<0.001)。黑色&白色标志的特异性为100%(95CI=97.6%-100%),阳性预测值为100%(95CI=76.8%-100%),总体准确率为82%(95CI=76%-87.1%)。在14名患有黑白病的患者中,13显示出绝对的血肿生长12mL,和10经历了超过初始体积的75%的HE。评分者之间的一致性非常好(kappa系数=0.84)。
■黑白征是血肿扩张发生和严重程度的可靠预测指标,然而,需要进一步验证来确认这些令人信服的发现.
UNASSIGNED: Existing radiological markers of hematoma expansion (HE) show modest predictive accuracy. We aim to investigate a novel radiological marker that co-localizes findings from non-contrast CT (NCCT) and CT angiography (CTA) to predict HE.
UNASSIGNED: Consecutive acute intracerebral hemorrhage patients admitted at Foothills Medical Centre in Calgary, Canada, were included. The Black-&-White sign was defined as any visually identified spot sign on CTA co-localized with a hypodensity sign on the corresponding NCCT. The primary outcome was hematoma expansion (⩾6 mL or ⩾33%). Secondary outcomes included absolute (<3, 3-6, 6-12, ⩾12 mL) and relative (0%, <25%, 25%-50%, 50%-75%, or >75%) hematoma growth scales.
UNASSIGNED: Two-hundred patients were included, with 50 (25%) experiencing HE. Forty-four (22%) showed the spot sign, 69 (34.5%) the hypodensity sign, and 14 (7%) co-localized both as the Black-&-White sign. Those with the Black-&-White sign had higher proportions of HE (100% vs 19.4%, p < 0.001), greater absolute hematoma growth (23.37 mL (IQR = 15.41-30.27) vs 0 mL (IQR = 0-2.39), p < 0.001) and relative hematoma growth (120% (IQR = 49-192) vs 0% (0-15%), p < 0.001). The Black-&-White sign had a specificity of 100% (95%CI = 97.6%-100%), a positive predictive value of 100% (95%CI = 76.8%-100%), and an overall accuracy of 82% (95%CI = 76%-87.1%). Among the 14 patients with the Black-&-White sign, 13 showed an absolute hematoma growth ⩾12 mL, and 10 experienced a HE exceeding 75% of the initial volume. The inter-rater agreement was excellent (kappa coefficient = 0.84).
UNASSIGNED: The Black-&-White sign is a robust predictor of hematoma expansion occurrence and severity, yet further validation is needed to confirm these compelling findings.