CT血管造影点征对早期脑出血患者预后的评估价值分析

Evaluated Value of CT Angiography Dot Signs on the Prognosis of Patients with Early Cerebral Hemorrhage

目的探讨CT血管造影(CTA)点征对早期脑出血患者预后的评估价值。方法回顾性分析2016年7月-2018年7月我院收治的48例早期脑出血患者的临床资料。发病6h内行急诊头颅CT平扫和CTA检查,根据CTA原始图像是否存在点征将48例患者分为2组。若患者病情恶化则及时复查CT,或发病24h后复查,计算血肿量,比较2组患者初诊和复诊血肿体积变化情况,评估CTA点征对血肿扩大的预测价值。结果48例患者中点征阳性12例(25.00%),点征阴性36例(75.00%);点征阳性者复诊血肿体积显著高于初诊血肿体积,且明显高于点征阴性者(P﹤0.05),点征阴性者初诊和复诊血肿体积比较,差异无统计学意义(P﹥0.05);CTA点征单独预测血肿扩大的灵敏度为73.33%(11/15),特异度为96.97%(32/33),准确率为89.58%(43/48),阳性预测值为91.67%(11/12),阴性预测值为88.89%(32/36)。结论CTA点征可为早期脑出血患者预后提供客观影像学指标,预测血肿扩大的准确性较高,有助于筛选出可能发生血肿扩大的高危患者,使这类患者治疗更为及时和准确。

Objective To explore the evaluated value of CT angiography (CTA) dot signs on the prognosis in patients with early cerebral hemorrhage.Methods The clinical data of 48 patients with early cerebral hemorrhage admitted to our hospital from July 2016 to July 2018 were retrospectively analyzed.The patients were given emergency CT plain scan and CTA examination within 6 h after onset,and 48 patients were divided into two groups according to whether there were any dot signs in the original CTA images.If the patient' s condition deteriorated,CT would be reviewed in time or review was given at 24 h after onset.The amount of hematoma was calculated,and the changes of hematoma volume at initial visit and return visit were compared between the two groups,and the predictive value of CTA dot signs on hematoma enlargement was evaluated.Results Among the 48 patients,12 cases (25.00%) were with positive dot signs and 36 cases (75.00%) were with negative dot signs.The hematoma volume at return visit in patients with positive dot signs was significantly higher than that at initial visit,and was significantly higher than that in patients with negative dot signs (P<0.05),and there was no significant difference in the hematoma volume between initial visit and return visit in patients with negative dot signs (P>0.05).The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of CTA dot signs in predicting hematoma enlargement were 73.33%(11/15),96.97%(32/33),89.58%(43/48),91.67%(11/12) and 88.89%(32/36). Conclusion CTA dot signs can provide objective imaging indicators for the prognosis of patients with early cerebral hemorrhage.And it has high accuracy in the prediction of hematoma enlargement,and it is helpful for screening high-risk patients who may be with hematoma enlargement,so that these patients can be treated more timely and accurately.