CT对动脉瘤性蛛网膜下腔出血患者脑池血容量与迟发性脑出血的相关性分析

The correlation between cisternal blood volume and delayed cerebral hemorrhage in patients with aneurysmal subarachnoid hemorrhage by CT

目的分析特异性位置的出血量与迟发性脑缺血相关联系。方法收集282位动脉瘤性蛛网膜下腔出血患者,并于24h内进行CT扫描。采用自动出血分割算法对血液总量进行量化,脑室内出血位置的被手动分类为脑池,脑室内,脑实质内和硬膜下。通过多变量逻辑回归分析计算脑室内出血位置的每毫升出血量与延迟脑缺血的相关性。结果我们共纳入了282例患者,研究显示每增加一毫升血液体积,延迟性脑缺血的调整优化值(OR值)分别为:脑室缺血为1.02(95%CI,1.01~1.04),脑室内缺血为1.02(95%CI,1.00~1.04),实质内缺血为0.99(95%CI,0.97~1.02),硬膜下缺血为0.96(95%CI,0.86~1.07)。结论在动脉瘤性蛛网膜下腔出血患者中,脑池出血量与脑缺血延迟的相关性最强。

Objective To quantitative analysis of specific location of the blood loss associated with late-onset cerebral ischemia.Methods Clinical data from in between January 2013 and December 2013,admitted during the period of 282-bit of aneurysmal subarachnoid hemorrhage,and CT scans within 24 hours.Adopting automatic segmentation algorithm to quantify the amount of blood,bleeding brain chamber bleeding position by manual classification for the pool,the brain,brain and subdural in essence.Intraventricular hemorrhage location by multivariate logistic regression analysis calculation per milliliter of blood loss and the correlation of delayed cerebral ischemia.Results We enrolled 282 patients,research has shown that for every milliliter blood volume,adjustment of delayed cerebral ischemia optimal value(OR values),respectively ventricular ischemia was 1.02(95%CI,1.01~1.04),the brain ischemia was 1.02(95%CI,1.00~1.04),the essence in ischemia was 0.99(95%CI,0.97~1.02),subdural ischemia was 0.96(95%CI,0.86~1.07).Conclusion In patients with aneurysmal subarachnoid hemorrhage,cerebral pool the bleeding and the strongest correlation of the delay in cerebral ischemia.