Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Cerebrovascular Diseases, The First People's Hospital of Zunyi, Zunyi, China.
World Neurosurg. 2019 Jul;127:e818-e825. doi: 10.1016/j.wneu.2019.03.273. Epub 2019 Apr 4.
Satellite sign (SS) and island sign (IS) are novel noncontrast computed tomography (CT) predictors of hematoma growth. The aim of this study was to compare diagnostic performance of IS and SS in predicting hematoma growth and functional outcome in patients with intracerebral hemorrhage (ICH).
The study included patients with ICH who underwent baseline CT scan within 6 hours of symptom onset and follow-up CT scan within 36 hours after initial CT between July 2012 and April 2017. Sensitivity, specificity, positive predictive value, and negative predictive value of IS and SS in predicting hematoma growth and functional outcome were assessed. Accuracy of the 2 signs in predicting hematoma growth and functional outcome was analyzed using receiver operating characteristic analysis. Association between the presence of IS and SS and ICH growth was assessed using multivariate logistic regression.
Of 307 patients with ICH, IS was observed in 46 patients (15.0%), and SS was observed in 151 patients (49.2%). Rates of hematoma growth were 40.4% in SS+ patients, 91.3% in IS+ patients, 18.4% in SS-IS- patients, 21.1% in SS+IS- patients, 100% in SS-IS+ patients, and 90.5% in SS+IS+ patients. After adjusting for potential confounders, IS remained an independent predictor for hematoma growth and poor functional outcome. The area under the curve of IS was significantly larger than the area under the curve of SS in predicting hematoma growth (P = 0.001).
IS seems to be an optimal shape irregularity imaging marker for predicting hematoma growth and functional outcome in patients with ICH.
卫星征（SS）和岛征（IS）是新型的非对比计算机断层扫描（CT）预测血肿增长的指标。本研究旨在比较 IS 和 SS 在预测脑出血（ICH）患者血肿增长和功能结局方面的诊断性能。
本研究纳入了 2012 年 7 月至 2017 年 4 月期间发病后 6 小时内行基线 CT 扫描且首次 CT 后 36 小时内行随访 CT 扫描的 ICH 患者。评估 IS 和 SS 在预测血肿增长和功能结局方面的敏感性、特异性、阳性预测值和阴性预测值。采用受试者工作特征曲线分析两种征象预测血肿增长和功能结局的准确性。采用多变量逻辑回归分析 IS 和 SS 的存在与 ICH 增长的相关性。
在 307 例 ICH 患者中，46 例（15.0%）患者存在 IS，151 例（49.2%）患者存在 SS。SS+患者血肿增长率为 40.4%，IS+患者为 91.3%，SS-IS-患者为 18.4%，SS+IS-患者为 21.1%，SS-IS+患者为 100%，SS+IS+患者为 90.5%。调整潜在混杂因素后，IS 仍然是血肿增长和不良功能结局的独立预测因子。IS 预测血肿增长的曲线下面积明显大于 SS（P=0.001）。
IS 似乎是预测 ICH 患者血肿增长和功能结局的最佳形态不规则性影像学标志物。
