BackgroundCerebral microbleeds (CMBs) are common in the hypertensive population and can only be detected with magnetic resonance imaging (MRI). The anticoagulation and thrombolytic regimens for patients with >5 CMBs are different from those for patients with ≤ 5 CMBs. However, MRI is not suitable for evaluating CMBs in patients with MRI contraindications or acute ischemic stroke urgently requiring thrombolysis. We aimed to develop and validate a nomogram combining clinical and brain computed tomography (CT) characteristics for predicting >5 CMBs in a hypertensive population.Materials and methodsIn total, 160 hypertensive patients from 2016 to 2020 who were confirmed by MRI to have >5 (77 patients) and ≤ 5 CMBs (83) were retrospectively analyzed as the training cohort. Sixty-four hypertensive patients from January 2021 to February 2022 were included in the validation cohort. Multivariate logistic regression was used to evaluate >5 CMBs. A combined nomogram was constructed based on the results, while clinical and CT models were established according to the corresponding characteristics. Receiver operating characteristic (ROC) and calibration curves and decision curve analysis (DCA) were used to verify the models.ResultsIn the multivariable analysis, the duration of hypertension, level of homocysteine, the number of lacunar infarcts (LIs), and leukoaraiosis (LA) score were included as factors associated with >5 CMBs. The clinical model consisted of the duration of hypertension and level of homocysteine, while the CT model consisted of the number of LIs and LA. The combined model consisted of the duration of hypertension, level of homocysteine, LI, and LA. The combined model achieved an area under the curve (AUC) of 0.915 (95% confidence interval [CI]: 0.860–0.953) with the training cohort and 0.887 (95% CI: 0.783–0.953) with the validation cohort, which were higher than those of the clinical model [training cohort: AUC, 0.797 (95% CI: 0.726, 0.857); validation cohort: AUC, 0.812 (95% CI: 0.695, 0.899)] and CT model [training cohort: AUC, 0.884 (95% CI: 0.824, 0.929); validation cohort: AUC, 0.868 (95% CI: 0.760, 0.940)]. DCA showed that the clinical value of the combined model was superior to that of the clinical model and CT model.ConclusionA combined model based on clinical and CT characteristics showed good diagnostic performance for predicting >5 CMBs in hypertensive patients.

No abstract

Eyelid epithelioid hemangioendothelioma (EHE) is uncommon. The present study reports the clinical, histopathological and immunohistochemical characteristics of a 10-year-old girl with EHE and reviews the related literature. The patient was admitted with a painless red mass on the left eyelid, which had been present for 6 months. Under the microscope, tumor cells from the surgical specimen were composed of epithelioid cells (70%) and spindle cells (30%). The cytoplasm was eosinophilic, and some areas of the cytoplasm showed signet ring-like or vacuolization changes. The presence of red blood cells could be seen in the luminal part of the primary blood vessel. Immunohistochemical results showed that the tumor cells were positive for CD34 and CD31, and the Ki-67 proliferation index was 3%. As the first resection margin was positive, recurrence occurred 3 months after surgery, Therefore, patients with such tumors should undergo full resections to ensure a negative margin to prevent recurrence.