ABSTRACT
Objective To explore the clinical significance of CT-angiography (CTA) in predicting hematoma enlargement in patients with acute hypertensive cerebral hemorrhage (HICH). Methods A prospective cohort study was performed on 50 patients with HICH. HICH and spot sign were diagnosed definitely by computerized tomography (CT) and CTA within 3 ~ 6 hours of symptom onset. Patients were dichotomized according to the presence or absence of the spot sign. CT scan was repeated immediately when patients′symptoms worsened or at 24 hours after onset of symptoms in order to find out the enlargement of hematomas. The relationship between hematoma expansion and spot sign of CTA was investigated. Results (1) Thirteen (26.0%) patients demonstrated the presence of spot sign of CTA, and 37 (74.0%) patients were without spot sign. Baseline clinical variables were similar in both groups. (2) Hematoma expansion occurred in 14 (28.0%) patients on follow-up. Eleven (84.6%) patients with and 3 (8.1%) patients without the spot sign of CTA were demonstrated hematoma expansion. The significance difference was found between the two groups (X2=24.27,P<0.05). Conclusions In acute HICH patients, CTA provided more radiological information and the CTA spot sign was associated with the presence of hematoma expansion. The spot sign will be recommended as an entry criterion for future trials of haemostatic therapy in patients with acute HICH.
ABSTRACT
Objective To explore the value of diffusion weighted imaging (DWI) in combination with susceptibility weighted imaging (SWI) in prognosis prediction of traumatic axonal injury (TAI).Methods A retrospective study of 75 patients with TAI was performed to analyze the clinical data and the follow-up prognosis in the 6 months after injury.The detection rate of TAI lesion by DWI,SWI and conventional MRI was compared.Multiple factors analysis applied logistic regression analysis to analyze the relationship between associated factors and prognosis.Results The average detected TAI lesions were (19.92 ± 8.62) by DWI and (22.17 ± 11.72) by SWI,which had no significant differences (t=1.24,P＞0.05),but there was a significant difference bettween by conventional MRI and by DWI or SWI (all P＜0.05).DWI was more sensitive to non-hemorrhagic lesions and SWI was more sensitive to hemorrhagic lesions.However,the lesions revealed by them existed the overlap of location and pathology of lesions.Patients with poor outcomes had more number of central lesions than those patient with good outcomes (t=2.455,P＜ 0.05).Logistic regression analysis revealed that the predictive accuracy provided by the combination with imaging and clinical factors was 95.7 ％.Conclusions DWI and SWI both are sensitive to TAI lesions,and have ability to detect the lesions with different pathological characteristics,separately.Accurate prognosis prediction for patients with TAI may be provided by the combination of clinical and imaging factors.