Clinical significance of CT-angiography spot sign in predicting hematoma enlargement in acute hypertensive cerebral hemorrhage / 实用医学杂志

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.