The imaging characteristics in intraparenchymal hemorrhage patients with hematoma expansion

Abstract

Objective To explore the imaging data of spontaneous intraparenchymal hemorrhage (sIPH) extracted from the Chinese Intracranial Hemorrhage Imaging Database (CICHID), and analyze the distribution of characteristics and features of hematoma expansion (HE) in patients with more than one non⁃contrast CT within 24 h. Methods There were 831 patients who received recurrent head CT scans involved the inclusion criteria analyzed from January 2016 to June 2020. The cutoff of HE was defined as 6 ml, and the patients were divided into HE group (≥ 6 ml) and non ⁃HE group (＜ 6 ml) to explore the characteristics of patients and their imaging. To explore more features, the HE group was subdivided into groups. According to the cutpoints of the expansion volume in hematoma volume, the groups were subdivided into group A (reduce/no change), group B (＜ 3 ml), group C (3-5.99 ml), group D (6-12.49 ml) and group E (≥ 12.50 ml). According to the expansion rate in hematoma volume, there were group F (＜ 26%), group G (26%-32%) and group H (≥ 33%). Results Among 831 patients, there were 155 patients (18.65%) with hematoma expansion. Compared to non ⁃ HE group, the patients in HE group had larger initial hematoma volume (t = ⁃ 6.148, P = 0.000), higher rate of hematoma breaking into ventricle (χ² = 20.812, P = 0.000) and shorter interval time between CTs (t = 2.306, P = 0.021). When subdivided as 3, 6 and 12.50 ml, there were significant differences among the groups, which including initial hematoma volume (H = 97.129, P = 0.000), rate of hematoma breaking into ventricle (χ² = 50.043, P = 0.000) and interval time between CTs (t = 2.306, P = 0.021), the initial hematoma volume (P = 0.014, 0.005, 0.000) and the rate of hematoma breaking into ventricle (P = 0.000, 0.000, 0.000) in 3-5.99 ml group, 6-12.49 ml group and ≥ 12.50 ml group were higher than ＜ 3 ml group, the interval time between CTs in ≥ 12.50 ml group was shorter than ＜ 3 ml group (P = 0.000). And subdivided as 26% and 33%, only the rate of hematoma breaking into ventricle showed significant difference among groups (χ² = 15.649, P = 0.001). Conclusions In the studies, there was 18.65% sIPH patients occurred HE within 24 h and the risk factors might be initial hematoma volume, rate of hemorrhage breaking into ventricle and interval time between CTs.

doi：10.3969/j.issn.1672⁃6731.2021.03.010