Objective To analyze the predictive efficacy of computed tomography (CT) signs in patients with spontaneous intracerebral hemorrhage (SICH) to improve the accuracy and effectiveness of early clinical intervention. Methods The clinical data of 282 patients with SICH admitted to our hospital from January 2021 to June 2024 were selected. The first head CT examination was performed within 6h after the onset of the disease, and the head CT examination was re-examined within 24h after the first examination. The patients were divided into an expanded group (93 cases) and an unexpanded group (189 cases) according to whether hematoma enlargement occurred. The baseline data and skull CT signs of the two groups were recorded in detail. Univariate and multivariate logistic regression were used to analyze the influencing factors of hematoma enlargement in SICH patients. The receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of skull CT signs in the prediction of hematoma enlargement in SICH patients. Results The results of single factor analysis showed that: initial hematoma, ventricle rupture, history of cerebral hemorrhage, admission systolic blood pressure (SBP), hybrid, vortex, black hole, satellite and island in the expanded group were all higher than those in the non-expanded group. Multivariate logistic regression analysis showed that the initial hematoma volume was large, and the history of cerebral hemorrhage was high, high proportion of mixed, high proportion of whirlpool, the proportion of black holes was high, and the proportion of satellites was high and high island ratio were independent risk factors for hematoma enlargement in SICH patients. The ROC curve results showed that the AUC of the enlarged hematoma in SICH patients predicted by the combination of skull CT signs was significantly higher than that predicted by skull CT signs alone. Conclusion Initial hematoma volume, previous history of intracerebral hemorrhage, mixed signs, vortex signs, black hole signs, satellite signs and other skull CT signs are independent predictors of hematoma expansion in SICH patients. In the process of diagnosis and treatment of SICH patients, clinicians should screen high-risk patients early and take timely intervention measures, which can help reduce hematoma expansion and improve the overall prognosis.
Key words
skull computed tomography findings /
spontaneous cerebral hemorrhage /
enlargement of hematoma /
predictive effectiveness
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