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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Michael T.J. Peeters (Department of Neurology University Medical Center Maastricht Netherlands) Kim J.D. de Kort (Department of Neurology University Medical Center Maastricht Netherlands) Rik Houben (Department of Neurology University Medical Center Maastricht Netherlands) Wouter J.P. Henneman (Department of Radiology University Medical Center Maastricht Netherlands) Robert J. van Oostenbrugge (Department of Neurology University Medical Center Maastricht Netherlands) Julie Staals (Department of NeurologyMaastricht University Medical Center Maastricht Netherlands) Alida A. Postma (Department of Radiology University Medical Center Maastricht Netherlands)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제23권 제1호
발행연도
2021.1
수록면
82 - 90 (9page)

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초록· 키워드

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Background and Purpose: Spot sign (SS) on computed tomography angiography (CTA) is associated with hematoma expansion (HE) and poor outcome after intracerebral hemorrhage (ICH). However, its predictive performance varies across studies, possibly because differentiating hyperdense hemorrhage from contrast media is difficult. We investigated whether dual-energy-CTA (DE-CTA),which can separate hemorrhage from iodinated contrast, improves the diagnostic accuracy of SS for predicting HE. Methods: Primary ICH patients undergoing DE-CTA (both arterial as well as delayed venous phase) and follow-up computed tomography were prospectively included between 2014 and 2019. SS was assessed on both arterial and delayed phase images of the different DE-CTA datasets, i.e., conventional-like mixed images, iodine images, and fusion images. Diagnostic accuracy of SS for prediction of HE was determined on all datasets. The association between SS and HE, and between SS and poor outcome (modified Rankin Scale at 3 months ≥3) was assessed with multivariable logistic regression, using the dataset with highest diagnostic accuracy. Results: Of 139 included patients, 47 showed HE (33.8%). Sensitivity of SS for HE was 32% (accuracy 0.72) on conventional-like mixed arterial images which increased to 76% (accuracy 0.80) on delayed fusion images. Presence of SS on delayed fusion images was independently associated with HE (odds ratio [OR], 17.5; 95% confidence interval [CI], 6.14 to 49.82) and poor outcome (OR, 3.84;95% CI, 1.16 to 12.73). Conclusions: Presence of SS on DE-CTA, in particular on delayed phase fusion images, demonstrates higher diagnostic performance in predicting HE compared to conventional-like mixed imaging, and it is associated with poor outcome.
#Computed tomography angiography #Cerebral hemorrhage #Intracranial hemorrhages #Spot sign #Prognosis

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참고문헌 (32)

참고문헌 신청
Van Asch CJ / 2010 / Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis / Lancet Neurol 9:167~176 google schola Xu X / 2018 / Accuracy of spot sign in predicting hematoma expansion and clinical outcome: a meta-analysis / Medicine(Baltimore) 97:e11945 google schola Brouwers HB / 2013 / Hematoma expansion following acute intracerebral hemorrhage / Cerebrovasc Dis 35:195~201 google schola Davis SM / 2006 / Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage / Neurology 66:1175~1181 google schola Brott T / 1997 / Early hemorrhage growth in patients with intracerebral hemorrhage / Stroke 28:1~5 google schola

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