Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Sci Rep. 2023 Jun 9;13(1):9447. doi: 10.1038/s41598-023-36042-2.
Spontaneous intraparenchymal cerebral hemorrhages (SIPH) account for 10-15% of acute strokes. Sorting these patients according to the risk of harboring an underlying vascular etiology may help selecting the patients who would mostly benefit from Multidetector CT Angiography (MDCTA). The aim of this study was to evaluate the accuracy of Non-Contrast brain CT (NCCT) in predicting possible vascular etiologies in patients with SIPH. In this retrospective study, we evaluated the NCCT of 334 patients who presented with SIPH from March 2017 to March 2021 and we looked for vascular etiologies in the CTA which was performed for these patients. We used NCCT criteria to predict the presence of any vascular etiologies in SIPH patients and proposed a scoring system based on these criteria which might predict the risk of vascular ICH (VICH score). Out of 334 evaluated patients, 9.3% had an underlying vascular etiology. Independent predictors of the vascular etiology included: age < 46 years, no history of hypertension and coagulation disorders, lobar hemorrhages, and presence of significant perilesional edema. We used these criteria and NCCT classification to create a practical scoring system to predict the risk of vascular ICH (VICH). In our study, VICH score ≥ 4 had 51.6% sensitivity and 96.4% specificity for predicting a positive MDCTA as the maximum optimal cut-off point. The VICH score seemed to be successful in predicting vascular etiologies in this retrospective cohort of 334 patients. This scoring system can be used to select patients if there are limited resources to perform CT angiography.
自发性脑实质内出血（SIPH）占急性中风的 10-15%。根据是否存在潜在血管病因的风险对这些患者进行分类，可能有助于选择最有可能从多排 CT 血管造影（MDCTA）中获益的患者。本研究旨在评估非对比脑 CT（NCCT）在预测 SIPH 患者潜在血管病因中的准确性。在这项回顾性研究中，我们评估了 2017 年 3 月至 2021 年 3 月期间因 SIPH 就诊的 334 例患者的 NCCT，并在这些患者中进行了 CTA 以寻找血管病因。我们使用 NCCT 标准来预测 SIPH 患者是否存在任何血管病因，并根据这些标准提出了一个评分系统，该评分系统可能预测血管性 ICH（VICH 评分）的风险。在 334 例评估患者中，9.3%存在潜在血管病因。血管病因的独立预测因素包括：年龄<46 岁、无高血压和凝血障碍病史、叶性出血和存在显著的病灶周围水肿。我们使用这些标准和 NCCT 分类创建了一个实用的评分系统来预测血管性 ICH（VICH）的风险。在我们的研究中，VICH 评分≥4 对预测 MDCTA 阳性具有 51.6%的敏感性和 96.4%的特异性，这是最大的最佳截断值。VICH 评分在 334 例回顾性队列患者中似乎成功地预测了血管病因。如果资源有限无法进行 CT 血管造影，这种评分系统可用于选择患者。
