Qi Li1, Gang Zhang2, Yuan-Jun Huang1, Mei-Xue Dong1, Fa-Jin Lv1, Xiao Wei1, Jian-Jun Chen1, Li-Juan Zhang1, Xin-Yue Qin1, Peng Xie2. 1. From the Departments of Neurology (Q.L., G.Z., Y.J.H, M.X.D., J.J.C., X.Y.Q., P.X.) and Radiology (F.J.L., L.J.Z.), The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; and Department of Medical Technology, Chongqing Medical and Pharmaceutical College, Chongqing, China (X.W.). 2. From the Departments of Neurology (Q.L., G.Z., Y.J.H, M.X.D., J.J.C., X.Y.Q., P.X.) and Radiology (F.J.L., L.J.Z.), The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; and Department of Medical Technology, Chongqing Medical and Pharmaceutical College, Chongqing, China (X.W.). peng_xie@yahoo.com drgangzhang@126.com.
Abstract
BACKGROUND AND PURPOSE: Early hematoma growth is not uncommon in patients with intracerebral hemorrhage and is an independent predictor of poor functional outcome. The purpose of our study was to report and validate the use of our newly identified computed tomographic (CT) blend sign in predicting early hematoma growth. METHODS: Patients with intracerebral hemorrhage who underwent baseline CT scan within 6 hours after onset of symptoms were included. The follow-up CT scan was performed within 24 hours after the baseline CT scan. Significant hematoma growth was defined as an increase in hematoma volume of >33% or an absolute increase of hematoma volume of >12.5 mL. The blend sign on admission nonenhanced CT was defined as blending of hypoattenuating area and hyperattenuating region with a well-defined margin. Univariate and multivariable logistic regression analyses were performed to assess the relationship between the presence of the blend sign on nonenhanced admission CT and early hematoma growth. RESULTS: A total of 172 patients were included in our study. Blend sign was observed in 29 of 172 (16.9%) patients with intracerebral hemorrhage on baseline nonenhanced CT scan. Of the 61 patients with hematoma growth, 24 (39.3%) had blend sign on admission CT scan. Interobserver agreement for identifying blend sign was excellent between the 2 readers (κ=0.957). The multivariate logistic regression analysis demonstrated that the time to baseline CT scan, initial hematoma volume, and presence of blend sign on baseline CT scan to be independent predictors of early hematoma growth. The sensitivity, specificity, positive and negative predictive values of blend sign for predicting hematoma growth were 39.3%, 95.5%, 82.7%, and 74.1%, respectively. CONCLUSIONS: The CT blend sign could be easily identified on regular nonenhanced CT and is highly specific for predicting hematoma growth.
BACKGROUND AND PURPOSE: Early hematoma growth is not uncommon in patients with intracerebral hemorrhage and is an independent predictor of poor functional outcome. The purpose of our study was to report and validate the use of our newly identified computed tomographic (CT) blend sign in predicting early hematoma growth. METHODS:Patients with intracerebral hemorrhage who underwent baseline CT scan within 6 hours after onset of symptoms were included. The follow-up CT scan was performed within 24 hours after the baseline CT scan. Significant hematoma growth was defined as an increase in hematoma volume of >33% or an absolute increase of hematoma volume of >12.5 mL. The blend sign on admission nonenhanced CT was defined as blending of hypoattenuating area and hyperattenuating region with a well-defined margin. Univariate and multivariable logistic regression analyses were performed to assess the relationship between the presence of the blend sign on nonenhanced admission CT and early hematoma growth. RESULTS: A total of 172 patients were included in our study. Blend sign was observed in 29 of 172 (16.9%) patients with intracerebral hemorrhage on baseline nonenhanced CT scan. Of the 61 patients with hematoma growth, 24 (39.3%) had blend sign on admission CT scan. Interobserver agreement for identifying blend sign was excellent between the 2 readers (κ=0.957). The multivariate logistic regression analysis demonstrated that the time to baseline CT scan, initial hematoma volume, and presence of blend sign on baseline CT scan to be independent predictors of early hematoma growth. The sensitivity, specificity, positive and negative predictive values of blend sign for predicting hematoma growth were 39.3%, 95.5%, 82.7%, and 74.1%, respectively. CONCLUSIONS: The CT blend sign could be easily identified on regular nonenhanced CT and is highly specific for predicting hematoma growth.
Authors: Andrea Morotti; H Bart Brouwers; Javier M Romero; Michael J Jessel; Anastasia Vashkevich; Kristin Schwab; Mohammad Rauf Afzal; Christy Cassarly; Steven M Greenberg; Renee Hebert Martin; Adnan I Qureshi; Jonathan Rosand; Joshua N Goldstein Journal: JAMA Neurol Date: 2017-08-01 Impact factor: 18.302
Authors: Gregoire Boulouis; Andrea Morotti; H Bart Brouwers; Andreas Charidimou; Michael J Jessel; Eitan Auriel; Octávio Pontes-Neto; Alison Ayres; Anastasia Vashkevich; Kristin M Schwab; Jonathan Rosand; Anand Viswanathan; Mahmut E Gurol; Steven M Greenberg; Joshua N Goldstein Journal: JAMA Neurol Date: 2016-08-01 Impact factor: 18.302
Authors: Gregoire Boulouis; Andrea Morotti; H Bart Brouwers; Andreas Charidimou; Michael J Jessel; Eitan Auriel; Octavio Pontes-Neto; Alison Ayres; Anastasia Vashkevich; Kristin M Schwab; Jonathan Rosand; Anand Viswanathan; Mahmut E Gurol; Steven M Greenberg; Joshua N Goldstein Journal: Stroke Date: 2016-09-06 Impact factor: 7.914
Authors: Gregoire Boulouis; Andrea Morotti; Andreas Charidimou; Dar Dowlatshahi; Joshua N Goldstein Journal: Stroke Date: 2017-03-13 Impact factor: 7.914
Authors: Andrea Morotti; Gregoire Boulouis; Andreas Charidimou; Kristin Schwab; Christina Kourkoulis; Christopher D Anderson; M Edip Gurol; Anand Viswanathan; Javier M Romero; Steven M Greenberg; Jonathan Rosand; Joshua N Goldstein Journal: Stroke Date: 2018-09 Impact factor: 7.914