The Predictive Value of Non-contrast CT for Intracerebral Hemorrhage Expansion

The primary purpose of the present meta-analysis was to systematically explore the non-contrast computed tomography (NCCT) signs for predicting hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH). Through a search of Pubmed, Web of Science and Embase, the diagnostic value of 10 NCCT signs, including heterogeneous density, irregular shape, blend sign, swirl sign, hypodensity, black hole sign, island sign, satellite sign, fluid levels, ultra-early hematoma growth, were combined and analyzed separately. After processing the data with the Stata 14.0 software, the study presented the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and posterior probability of various signs. The results showed none of the signs has high sensitivity and specificity at the same time, which may be the defect of using NCCT to predict HE. Nevertheless, the island sign may have a better predictive value in practice due to the higher positive likelihood ratios of 6.6 (95% CI, 3.4-12.9).