“Dynamic spot sign” on computed tomography perfusion source images(CTP-SI) predicts hematoma expansion in acute intracerebral hemorrhage

doi:10.3969/j.issn.1006-7795.2017.01.015

Abstract

Abstract: Objective To evaluate the association between the presence of tiny dynamic progressive enhancing foci ("dynamic spot sign") in acute intracerebral hematoma on computed tomography perfusion source images (CTP-SI) and hematoma expansion. Methods Totally 121 consecutive patients with spontaneous intracerebral hemorrhage (ICH) by no-contrast-enhanced CT (NCCT), computed tomography perfusion(CTP) examination within 6 hours after symptom onset were included in this prospective study. Imaging data were evaluated by two experienced radiologists. Patients were dichotomized according to the presence or absence of the dynamic spot sign on CTP-SI in hematoma. Clinical and radiological outcomes were compared between groups. The predictive value of this sign was assessed in univariate and multivariate regression analysis.Results Hematoma expansion occurred in 28 patients (25.0%) on follow-up. Thirty patients (26.8%) were demonstrated dynamic spot sign. On CTP-SI, about 25(83.3%) patients with hematoma expansion and 5 (16.7%) without demonstrated by the dynamic spot sign were pound. Sensitivity, specificity, positive predictive value, negative predictive value, and Kappa value for expansion were 89.3%, 94.0%, 83.3%, 96.3%, and Kappa is 0.814 (P<0.001), respectively. Interobserver agreement was high (κ=0.92). In multiple regression, the presence of CTP dynamic spot sign within acute hematomas independently predicted hematoma expansion, univariate analysis OR value was 131.667(29.386-590.289)(P<0.000 1). Moreover, multivariate analysis CTP dynamic spot sign OR value was 203.996 (32.123-1295.488)(P<0.000 1).Conclusion The computed tomography perfusion source images dynamic spot sign is associated with the presence and extent of hematoma expansion. CTP dynamic spot sign is more direct for showing active ongoing bleeding. It can be used as a guide for further strengthening the treatment and monitoring of patients with cerebral hemorrhage.

Key words: computed tomography perfusion, intracerebral hemorrhage, prognosis, stroke

CLC Number:

R445

Sun Shengjun, Han Liping, Su Yaping, Gao Peiyi. “Dynamic spot sign” on computed tomography perfusion source images(CTP-SI) predicts hematoma expansion in acute intracerebral hemorrhage[J]. Journal of Capital Medical University, 2017, 38(1): 72-77.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2017.01.015

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2017/V38/I1/72

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