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目的评估脑CT血管造影(CTA)原始图像斑点征对高血压脑出血(HICH)血肿扩大的预测价值。方法 HICH患者115例,在发病6h内行急诊头颅CT平扫和CTA同步检查。患者临床症状恶化即时或者常规发病后24h复查头颅CT平扫,根据多田公式计算血肿量。以血肿有无增大分为血肿增大组(28例)和无血肿增大组(87例),比较两组斑点征的阳性率。结果两组患者年龄、性别构成比、入院时血压及入院时GCS评分均无统计学差异(P>0.05),而两组之间的出血部位、初次CT平扫的血肿形态以及首次血肿量有统计学差异(P<0.05)。血肿增大组斑点征阳性率高于无血肿增大组(67.9%vs.11.5%)(P<0.05)。结论头颅CTA原始图像斑点征可为HICH患者血肿扩大提供客观影像学指标。
Objective To evaluate the predictive value of primary CT scintigraphy (CTA) speckle sign on the enlargement of hypertensive intracerebral hemorrhage (HICH) hematoma. Methods One hundred and fifteen patients with HICH underwent emergency head CT scan and CTA simultaneously within 6 hours after onset. Patients with deteriorating clinical symptoms or routine onset of 24h after recurrent skull CT scan, according to Tada formula to calculate the amount of hematoma. Whether hematoma enlargement was divided into hematoma enlargement group (28 cases) and no hematoma enlargement group (87 cases), the positive rate of the two groups were compared. Results There were no significant differences in the age and sex ratio, blood pressure at admission and GCS scores at admission (P> 0.05). However, the bleeding site, initial CT scan, Statistical difference (P <0.05). The positive rate of spot syndrome in hematoma enlargement group was higher than that in non-hematoma enlargement group (67.9% vs.11.5%) (P <0.05). Conclusion The CTA original image speckle sign can provide objective imaging index for hematoma enlargement of HICH patients.