Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China.
Clin Neurol Neurosurg. 2022 Nov;222:107443. doi: 10.1016/j.clineuro.2022.107443. Epub 2022 Sep 15.
To determine the prognostics significance of the computed tomography (CT) 3D island sign for predicting early perihematomal edema (PHE) expansion and poor functional outcome in patients presenting with intracerebral hemorrhage (ICH).
Between July 2011 and March 2017, patients with intracerebral hemorrhage who had undergone baseline CT within 6 h after ICH symptom onsets and follow-up CT in our hospital were included. Two different readers independently assessed the presence of 3D island sign on admission CT scan of each patient. Multivariable logistic regression analysis was used to analyze association between 3D island sign and early perihematomal edema expansion and poor functional outcome, separately.
A total of 214 patients who met the inclusion criteria were included in our study, 3D island sign was observed in 60 patients (28.0 %) on admission CT scan. The multivariate logistic regression analysis demonstrated that baseline hematoma volume, time to baseline and follow-up CT scans and the presence of 3D island sign were predictors of early PHE expansion. After adjusting for age, baseline hematoma and edema volume, time to baseline and follow-up CT scans, GCS on admission, presence of intraventricular hemorrhage (IVH) and systolic blood pressure, the 3D island sign was an independently imaging marker for poor outcome (OR, 2.803; 95 % confidence interval, 1.189-6.609; P = 0.018).
The 3D island sign in patients with intracerebral hemorrhage was a reliable predictor for early perihematomal edema expansion and poor functional outcome. It may serve as a potential therapeutic target for intervention.
本研究旨在明确 CT 三维岛征对于预测脑出血患者血肿周围早期水肿（PHE）扩大和不良功能结局的预后意义。
本研究纳入了 2011 年 7 月至 2017 年 3 月期间在我院接受治疗的脑出血患者，这些患者在脑出血症状发作后 6 h 内接受了基线 CT 检查，并进行了随访 CT 检查。两位不同的读者分别独立评估了每位患者入院 CT 扫描中是否存在三维岛征。多变量逻辑回归分析用于分析三维岛征与早期血肿周围水肿扩大和不良功能结局之间的关系。
共有 214 名符合纳入标准的患者纳入本研究，其中 60 名（28.0%）患者在入院 CT 扫描中存在三维岛征。多变量逻辑回归分析表明，基线血肿体积、基线和随访 CT 扫描时间以及三维岛征的存在是早期 PHE 扩大的预测因素。在校正了年龄、基线血肿和水肿体积、基线和随访 CT 扫描时间、入院时 GCS、是否存在脑室内出血（IVH）和收缩压后，三维岛征是不良结局的独立影像学标志物（OR，2.803；95%置信区间，1.189-6.609；P=0.018）。
脑出血患者的三维岛征是预测早期血肿周围水肿扩大和不良功能结局的可靠指标。它可能成为干预治疗的潜在靶点。
