高血压脑出血患者CT血管造影成像特点与脑内血肿的关系研究

Relation between CT angiography imaging manifestation and intracerebral hematoma in patients with hypertensive cerebral hemorrhage

目的探究高血压脑出血(HCH)患者CT血管造影(CTA)成像特点与脑内血肿的关系。方法回顾性分析2017年8月至2018年11月在江苏省如皋市人民医院诊治的120例HCH患者,均在入院后立即开展CTA检查。观察统计患者的影像学点征情况、血肿量增加情况,并分析二者之间的相关性。结果通过对患者的48 h CTA随访,发现血肿扩大48例,非血肿扩大72例。血肿扩大患者的点征阳性率明显高于非血肿扩大患者[87. 5%(42/48)比5. 6%(4/72)],差异有统计学意义(χ^2=81. 812,P <0. 001)。点征阳性患者的血肿增加量明显大于点征阴性患者[(15. 6±2. 3) ml比(2. 9±1. 3) ml],血肿扩大患者的血肿增加量明显大于非血肿扩大患者[(14. 7±2. 3) ml比(2. 8±1. 0) ml],差异均有统计学意义(χ^2=33. 579、34. 247,均P <0. 001)。Spearman相关性分析显示,患者血肿增加量与点征阳性率呈正相关(r=1. 362,P <0. 001)。结论 HCH患者的CTA影像学中的点征表现与血肿扩大情况呈现明显相关,针对此类患者,应及时进行干预,预防再出血以及血肿扩大。

Objective To analyze the relation between CT angiography(CTA)imaging manifestation and intracerebral hematoma in patients with hypertensive cerebral hemorrhage(HCH).Methods A retrospective study was performed on 120 patients with HCH in the People’s Hospital of Rugao,Jiangsu Province from August2017 to November 2018.All patients had CTA immediately after admission.Relation between CTA point signs and hematoma volume was analyzed.Results CTA showed hematoma enlargement in 48 patients in 48 h after admission.Higher rate of point signs in CTA was observed in patients with hematoma enlargement[87.5%(42/48)vs 5.6%(4/72)](χ^2=81.812,P<0.001).Hematoma volume increased more significantly in 48 h in patients with CTA point signs[(15.6±2.3)ml vs(2.9±1.3)ml]and patients with hematoma enlargement[(14.7±2.3)ml vs(2.8±1.0)ml](χ^2=33.579,34.247,both P<0.001).Spearman test showed positive correlation between the increase of hematoma volume and the rate of CTA signs(r=1.362,P<0.001).Conclusion CTA signs is correlated with hematoma enlargement in HCH patients;early intervention should be performed on these patients to prevent re-bleeding and disease deterioration.