Research Progress on the Predictive Value of Heterogeneous Hematoma Density on NCCT for Hematoma Expansion and Poor Prognosis in Patients with Spontaneous Intracerebral Hemorrhage

doi:10.3969/j.issn.1673-5765.2025.08.013

Abstract

Abstract: Spontaneous intracerebral hemorrhage is a stroke subtype characterized by high morbidity and mortality. It encompasses hypertensive cerebral hemorrhage, cerebral amyloid angiopathy-related intracerebral hemorrhage, and cryptogenic intracerebral hemorrhage. Hematoma expansion is considered one of the risk factors for poor prognosis in patients with spontaneous intracerebral hemorrhage. Prophylactic treatment for spontaneous intracerebral hemorrhage patients at risk of hematoma expansion may improve their outcomes. Therefore, reliable imaging biomarkers for the rapid screening of high-risk patients with hematoma expansion have become a focus in clinical research. In recent years, a large number of clinical studies have shown that heterogeneous hematoma density on head non-contrast computed tomography is a predictor of hematoma expansion and poor prognosis in patients with spontaneous intracerebral hemorrhage. However, this conclusion remains controversial. This article systematically reviews and summarizes the related research progress, aiming to provide references for clinical diagnosis and treatment.

Key words: Spontaneous intracerebral hemorrhage; Imaging marker; Multimodal imaging; Prognosis; Hematoma expansion

摘要： 自发性脑出血是一种高发病率、高死亡率的卒中类型，主要有高血压脑出血、脑淀粉样血管病脑出血及原因不明脑出血。血肿扩大是自发性脑出血患者预后不良的危险因素之一。对存在血肿扩大风险的自发性脑出血患者进行预防性治疗可能改善其预后，因此，用于快速筛选血肿扩大高危患者的可靠影像学标志物已成为临床研究的重点。近年来大量研究表明，头颅非对比计算机断层扫描血肿密度不均匀是自发性脑出血患者血肿扩大及预后不良的预测因子，但目前该结论仍存在争议。本文对相关研究进展进行系统整理和归纳，以期为临床诊疗提供参考。

关键词: 自发性脑出血; 影像学标志物; 多模态影像; 预后; 血肿扩大

CLC Number:

FU Yuanyuan, WANG Likun. Research Progress on the Predictive Value of Heterogeneous Hematoma Density on NCCT for Hematoma Expansion and Poor Prognosis in Patients with Spontaneous Intracerebral Hemorrhage[J]. Chinese Journal of Stroke, 2025, 20(8): 1035-1041.

付媛媛, 王丽琨. NCCT血肿密度不均匀对自发性脑出血患者血肿扩大及预后不良预测价值的研究进展[J]. 中国卒中杂志, 2025, 20(8): 1035-1041.

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