Chen Yong, Cao Dan, Guo Zheng-Qian, Ma Xiao-Ling, Ou Yi-Bo, He Yue, Chen Xu, Chen Jian
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Neurol. 2022 Apr 8;13:785670. doi: 10.3389/fneur.2022.785670. eCollection 2022.
The ability of attenuation value of the non-hypodense region of hematoma in non-contrast computed tomography (NCCT) for predicting hematoma expansion (HE) remains unclear. Our purpose is to explore this relationship.
Two cohorts of patients were collected for analysis. The region where we measured hematoma attenuation values was limited to the non-hypodense region that was not adjacent to the normal brain tissue on NCCT. The critical attenuation value was derived receiver operating characteristic (ROC) curve analysis in the derivation cohort and its predictive ability was validated in the validation cohort. Independent relationships between predictors, such as critical attenuation value of the non-hypodense region and HE were analyzed using the least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic analysis.
The results showed that the attenuation value <64 Hounsfield units (HU) was independently associated with HE [odds ratio (), 4.118; 95% confidential interval (), 1.897-9.129, < 0.001] and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the curve (AUC) for predicting HE were 36.11%, 81.71%, 1.97, 0.78, 44.8%, 75.7%, and 0.589, respectively.
Our research explored and validated the relationship between the attenuation value of the non-hypodense region of hematoma and HE. The attenuation value < 64 HU was an appropriate indicator of early HE.
非增强计算机断层扫描（NCCT）中血肿非低密度区域的衰减值预测血肿扩大（HE）的能力尚不清楚。我们的目的是探究这种关系。
收集两组患者进行分析。我们测量血肿衰减值的区域限于NCCT上不与正常脑组织相邻的非低密度区域。通过在推导队列中进行受试者操作特征（ROC）曲线分析得出临界衰减值，并在验证队列中验证其预测能力。使用最小绝对收缩和选择算子（LASSO）回归及多变量逻辑分析来分析预测指标（如非低密度区域的临界衰减值）与HE之间的独立关系。
结果显示，衰减值<64亨氏单位（HU）与HE独立相关[比值比（OR），4.118；95%置信区间（CI），1.897 - 9.129，P < 0.001]，预测HE的灵敏度、特异度、阳性预测值（PPV）、阴性预测值（NPV）、阳性似然比（PLR）、阴性似然比（NLR）和曲线下面积（AUC）分别为36.11%、81.71%、1.97、0.78、44.8%、75.7%和0.589。
我们的研究探究并验证了血肿非低密度区域的衰减值与HE之间的关系。衰减值<64 HU是早期HE的合适指标。
