Li Qi, Yang Wen-Song, Wang Xing-Chen, Cao Du, Zhu Dan, Lv Fa-Jin, Liu Yang, Yuan Liang, Zhang Gang, Xiong Xin, Li Rui, Hu Yun-Xin, Qin Xin-Yue, Xie Peng
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
PLoS One. 2017 Aug 22;12(8):e0183082. doi: 10.1371/journal.pone.0183082. eCollection 2017.
Blend sign has been recently described as a novel imaging marker that predicts hematoma expansion. The purpose of our study was to investigate the prognostic value of CT blend sign in patients with ICH.
Patients with intracerebral hemorrhage who underwent baseline CT scan within 6 hours were included. The presence of blend sign on admission nonenhanced CT was independently assessed by two readers. The functional outcome was assessed by using the modified Rankin Scale (mRS) at 90 days.
Blend sign was identified in 40 of 238 (16.8%) patients on admission CT scan. The proportion of patients with a poor functional outcome was significantly higher in patients with blend sign than those without blend sign (75.0% versus 47.5%, P = 0.001). The multivariate logistic regression analysis demonstrated that age, intraventricular hemorrhage, admission GCS score, baseline hematoma volume and presence of blend sign on baseline CT independently predict poor functional outcome at 90 days. The CT blend sign independently predicts poor outcome in patients with ICH (odds ratio 3.61, 95% confidence interval [1.47-8.89];p = 0.005).
Early identification of blend sign is useful in prognostic stratification and may serve as a potential therapeutic target for prospective interventional studies.
融合征最近被描述为一种预测血肿扩大的新型影像学标志物。我们研究的目的是探讨CT融合征在脑出血患者中的预后价值。
纳入在6小时内接受基线CT扫描的脑出血患者。由两名阅片者独立评估入院时非增强CT上融合征的存在情况。在90天时使用改良Rankin量表（mRS）评估功能结局。
在238例患者中的40例（16.8%）入院CT扫描中发现融合征。有融合征的患者功能结局不良的比例显著高于无融合征的患者（75.0%对47.5%，P = 0.001）。多因素逻辑回归分析表明，年龄、脑室内出血、入院时格拉斯哥昏迷量表（GCS）评分、基线血肿体积以及基线CT上融合征的存在独立预测90天时功能结局不良。CT融合征独立预测脑出血患者结局不良（比值比3.61，95%置信区间[1.47 - 8.89]；P = 0.005）。
早期识别融合征有助于预后分层，并且可能作为前瞻性干预研究的潜在治疗靶点。
