Zheng Jun, Yu Zhiyuan, Guo Rui, Li Hao, You Chao, Ma Lu
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
World Neurosurg. 2018 Jul;115:e711-e716. doi: 10.1016/j.wneu.2018.04.140. Epub 2018 Apr 27.
Hematoma expansion is related to unfavorable prognosis in intracerebral hemorrhage (ICH). The black hole sign is a novel marker on non-contrast computed tomography for predicting hematoma expansion. However, its predictive values are different in previous studies. Thus, this meta-analysis was conducted to evaluate the predictive significance of the black hole sign for hematoma expansion in ICH.
A systematic literature search was performed. Original researches on the association between the black hole sign and hematoma expansion in ICH were included. Sensitivity and specificity were pooled to assess the predictive accuracy. Summary receiver operating characteristics curve (SROC) was developed. Deeks' funnel plot asymmetry test was used to assess the publication bias.
Five studies with a total of 1495 patients were included in this study. The pooled sensitivity and specificity of the black hole sign for predicting hematoma expansion were 0.30 and 0.91, respectively. The area under the curve was 0.78 in SROC curve. There was no significant publication bias.
This meta-analysis shows that the black hole sign is a helpful imaging marker for predicting hematoma expansion in ICH. Although the black hole sign has a relatively low sensitivity, its specificity is relatively high.
血肿扩大与脑出血（ICH）的不良预后相关。黑洞征是一种用于预测血肿扩大的非增强计算机断层扫描的新标志物。然而，其预测价值在以往研究中有所不同。因此，进行了这项荟萃分析以评估黑洞征对ICH血肿扩大的预测意义。
进行了系统的文献检索。纳入了关于ICH中黑洞征与血肿扩大之间关联的原始研究。汇总敏感性和特异性以评估预测准确性。绘制了汇总受试者工作特征曲线（SROC）。使用Deeks漏斗图不对称性检验来评估发表偏倚。
本研究纳入了5项研究，共1495例患者。黑洞征预测血肿扩大的汇总敏感性和特异性分别为0.30和0.91。SROC曲线下面积为0.78。没有明显的发表偏倚。
这项荟萃分析表明，黑洞征是预测ICH血肿扩大的一个有用的影像学标志物。尽管黑洞征的敏感性相对较低，但其特异性相对较高。
