OBJECTIVES: To evaluate the association between dynamic progressive enhancing foci ("dynamic spot sign") in acute haematoma on CT perfusion source images (CTP-SI) and haematoma expansion. METHODS: One hundred twelve consecutive patients with spontaneous intracerebral haemorrhage according to unenhanced CT, CTP and CT angiography within 6 h of symptom onset were prospectively evaluated. Patients were dichotomised according to the presence/absence of the dynamic spot sign on CTP-SI in haematoma. The predictive value of haematoma expansion was analysed. RESULTS: Haematoma expansion was detected in 28 patients (25.0 %) on follow-up unenhanced CT images. Thirty patients (26.8 %) demonstrated the dynamic spot sign on CTP-SI, about 83.3 % of patients with haematoma expansion (P < 0.001). Sensitivity, specificity, positive predictive value, negative predictive value and kappa value for expansion were 89.3 %, 94.0 %, 96.3 %, 83.3 % and 0.814, respectively. In multiple regression, the presence of the CTP dynamic spot sign within acute haematomas independently predicted haematoma expansion; the univariate analysis OR value was 131.667 (29.386-590.289), P < 0.0001. Moreover, the multivariate analysis CTP dynamic spot sign OR value was 203.996 (32.123-1295.488), P < 0.0001. CONCLUSIONS: The CTP-SI dynamic spot sign is associated with acute haematoma expansion, is more direct in showing active ongoing bleeding and has a higher predictive value than the CTA spot sign. KEY POINTS: • It is important to identify potential progression of spontaneous intracerebral haemorrhage. • Dynamic enhancement within CT perfusion source images is associated with haemorrhage expansion. • The CTP dynamic spot sign may be present throughout arterial to venous phase imaging. • The CTP dynamic spot sign carries a higher predive value for haematoma expansion than CTA.
OBJECTIVES: To evaluate the association between dynamic progressive enhancing foci ("dynamic spot sign") in acute haematoma on CT perfusion source images (CTP-SI) and haematoma expansion. METHODS: One hundred twelve consecutive patients with spontaneous intracerebral haemorrhage according to unenhanced CT, CTP and CT angiography within 6 h of symptom onset were prospectively evaluated. Patients were dichotomised according to the presence/absence of the dynamic spot sign on CTP-SI in haematoma. The predictive value of haematoma expansion was analysed. RESULTS: Haematoma expansion was detected in 28 patients (25.0 %) on follow-up unenhanced CT images. Thirty patients (26.8 %) demonstrated the dynamic spot sign on CTP-SI, about 83.3 % of patients with haematoma expansion (P < 0.001). Sensitivity, specificity, positive predictive value, negative predictive value and kappa value for expansion were 89.3 %, 94.0 %, 96.3 %, 83.3 % and 0.814, respectively. In multiple regression, the presence of the CTP dynamic spot sign within acute haematomas independently predicted haematoma expansion; the univariate analysis OR value was 131.667 (29.386-590.289), P < 0.0001. Moreover, the multivariate analysis CTP dynamic spot sign OR value was 203.996 (32.123-1295.488), P < 0.0001. CONCLUSIONS: The CTP-SI dynamic spot sign is associated with acute haematoma expansion, is more direct in showing active ongoing bleeding and has a higher predictive value than the CTA spot sign. KEY POINTS: • It is important to identify potential progression of spontaneous intracerebral haemorrhage. • Dynamic enhancement within CT perfusion source images is associated with haemorrhage expansion. • The CTP dynamic spot sign may be present throughout arterial to venous phase imaging. • The CTP dynamic spot sign carries a higher predive value for haematoma expansion than CTA.
Authors: S M Davis; J Broderick; M Hennerici; N C Brun; M N Diringer; S A Mayer; K Begtrup; T Steiner Journal: Neurology Date: 2006-04-25 Impact factor: 9.910
Authors: H Bart Brouwers; Guido J Falcone; Kristen A McNamara; Alison M Ayres; Alexandra Oleinik; Kristin Schwab; Javier M Romero; Anand Viswanathan; Steven M Greenberg; Jonathan Rosand; Joshua N Goldstein Journal: Neurocrit Care Date: 2012-12 Impact factor: 3.210
Authors: Josser E Delgado Almandoz; Albert J Yoo; Michael J Stone; Pamela W Schaefer; Joshua N Goldstein; Jonathan Rosand; Alexandra Oleinik; Michael H Lev; R Gilberto Gonzalez; Javier M Romero Journal: Stroke Date: 2009-07-02 Impact factor: 7.914
Authors: Brian L Hoh; Arnold C Cheung; James D Rabinov; Johnny C Pryor; Bob S Carter; Christopher S Ogilvy Journal: Neurosurgery Date: 2004-06 Impact factor: 4.654
Authors: Michael Quangminh Truong; Andrew Viggo Metcalfe; Christopher Dillon Ovenden; Timothy John Kleinig; Christen David Barras Journal: Neuroradiology Date: 2022-09-09 Impact factor: 2.995
Authors: Viesha A Ciura; H Bart Brouwers; Raffaella Pizzolato; Claudia J Ortiz; Jonathan Rosand; Joshua N Goldstein; Steven M Greenberg; Stuart R Pomerantz; R Gilberto Gonzalez; Javier M Romero Journal: Stroke Date: 2014-10-09 Impact factor: 7.914
Authors: Santanu Chakraborty; Mohammed Alhazzaa; Jason K Wasserman; Yang Yang Sun; Grant Stotts; Mathew J Hogan; Andrew Demchuk; Richard I Aviv; Dar Dowlatshahi Journal: PLoS One Date: 2014-03-03 Impact factor: 3.240