Uchiyama Yuki, Domen Kazuhisa, Koyama Tetsuo
Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan.
Prog Rehabil Med. 2021 Dec 10;6:20210050. doi: 10.2490/prm.20210050. eCollection 2021.
This study investigated the potential utility of computed tomography for outcome prediction in patients with intracerebral hemorrhage.
Patients with putaminal and/or thalamic hemorrhage for whom computed tomography images were acquired in our hospital emergency room soon after onset were retrospectively enrolled. Outcome measurements were obtained at discharge from the convalescent rehabilitation ward of our affiliated hospital. Hemiparesis was evaluated using the total score of the motor component of the Stroke Impairment Assessment Set (SIAS-motor; null to full, 0 to 25), the motor component of the Functional Independence Measure (FIM-motor; null to full, 13 to 91), and the total length of hospital stay. After registration of the computed tomography images to the standard brain, the volumes of the hematoma lesions located in the corticospinal tract were calculated. The correlation between the corticospinal tract lesion volumes and the outcome measurements was assessed using Spearman's rank correlation test.
Thirty patients were entered into the final analytical database. Corticospinal tract lesion volumes ranged from 0.002 to 4.302 ml (median, 1.478). SIAS-motor scores ranged from 0 to 25 (median, 20), FIM-motor scores ranged from 15 to 91 (median, 80.5), and the total length of hospital stay ranged from 31 to 194 days (median, 106.5). All correlation tests were statistically significant (P <0.01). The strongest correlation was for SIAS-motor total (R=-0.710), followed by FIM-motor (R=-0.604) and LOS (R=0.493).
These findings suggest that conventional computed tomography images may be useful for outcome prediction in patients with intracerebral hemorrhage.
本研究探讨计算机断层扫描在脑出血患者预后预测中的潜在效用。
回顾性纳入在我院急诊室发病后不久获得计算机断层扫描图像的壳核和/或丘脑出血患者。在我院附属医院康复病房出院时进行预后评估。使用卒中损伤评估量表运动部分总分（SIAS-运动；无至完全，0至25分）、功能独立性测量运动部分（FIM-运动；无至完全，13至91分）以及住院总时长评估偏瘫情况。将计算机断层扫描图像配准到标准脑模板后，计算位于皮质脊髓束的血肿病变体积。使用Spearman等级相关检验评估皮质脊髓束病变体积与预后指标之间的相关性。
30例患者进入最终分析数据库。皮质脊髓束病变体积范围为0.002至4.302毫升（中位数为1.478）。SIAS-运动评分范围为0至25分（中位数为20分），FIM-运动评分范围为15至91分（中位数为80.5分），住院总时长范围为31至194天（中位数为106.5天）。所有相关性检验均具有统计学意义（P<0.01）。相关性最强的是SIAS-运动总分（R=-0.710），其次是FIM-运动（R=-0.604）和住院时长（R=0.493）。
这些发现表明，传统计算机断层扫描图像可能有助于脑出血患者的预后预测。
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