头颅CT影像学指标评估自发性脑出血患者血肿的临床价值

Evaluation of Hematoma in Patients with Spontaneous Cerebral Hemorrhage by Head CT Imaging

目的 探讨头颅CT影像学指标评估自发性脑出血患者血肿的临床价值。方法 选取2018年3月至2020年4月我院收治的200例自发性脑出血患者,对其进行头颅CT影像学检查。根据CT图像显示比较血肿扩大、无扩大患者不同征象及征象对其诊断价值。结果 200例患者经头颅CT检查显示,85例患者血肿扩大,115例血肿无扩大。血肿扩大患者其CT图像显示血肿不规则、周边散在卫星小血肿及血肿混杂密度病例数多于血肿无扩大患者(P<0.05)。血肿不规则征象诊断的准确性、灵敏度及特异性分别为82.50%、82.30%、82.30%,周边散在卫星小血肿征象分别为78.80%、70.50%、87.00%,血肿混杂密度征象分别为77.30%、58.80%、95.70%。结论血肿不规则、周边存在小血肿及血肿密度不均匀等头颅CT影像学征象可为自发性脑出血患者血肿继续扩大提供预示,对诊断、治疗具有参考价值,值得推广。

Objective To investigate the value of head CT imaging in the evaluation of hematoma in patients with spontaneous cerebral hemorrhage. Methods 200 patients with spontaneous cerebral hemorrhage in our hospital from March 2018 to April 2020 were enrolled, and received head CT examinations. CT signs of patients with enlarged hematoma and those without enlarged hematoma were compared,and the diagnostic value of those signs was verified. Results CT examination of 200 patients showed that 85 patients had enlarged hematoma and 115 patients had no enlarged hematoma. The proportion of irregular hematoma margin, peripherally scattered small hematoma and mixed density among patients with enlarged hematoma was higher than that of patientswithout enlarged hematoma(P<0.05). The accuracy, sensitivity and specificity of irregular hematoma margin were 82.50%, 82.30%,82.30%, those of peripherally scattered small hematoma were 78.80%, 70.50%, 87.00%, and those of mixed density signs were 77.30%, 58.80%, 95.70%. Conclusion CT signs including irregular hematoma margin, peripherally scattered small hematoma and mixed density can provide a prediction for potential hematoma enlargement in patients with spontaneous intracerebral hemorrhage, which has important reference value for the clinical diagnosis and treatment.