Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing 400016, China.
Department of Physiology and Pharmacology, Loma Linda University School of Medicine, 11041 Campus Street, Risley Hall, Room 219, Loma Linda, CA 92354, USA.
Biomed Res Int. 2017;2017:4137210. doi: 10.1155/2017/4137210. Epub 2017 Aug 9.
Hematoma expansion (HE) occurs in approximately one-third of patients with intracerebral hemorrhage and leads to high rates of mortality and morbidity. Currently, contrast extravasation within hematoma, termed the spot sign on computed tomography angiography (CTA), has been identified as a strong independent predictor of early hematoma expansion. Past studies indicate that the spot sign is a dynamic entity and is indicative of active hemorrhage. Furthermore, to enhance the spot sign's accuracy of predicting HE, spot parameters observed on CTA or dynamic CTA were used for its quantification. In addition, spot signs detected on multiphase CTA and dynamic CTA are shown to have higher sensitivity and specificity when compared with simple standardized spot sign detection in recent studies. Based on the spot sign, novel methods such as leakage sign and rate of contrast extravasation were explored to redefine HE prediction in combination with clinical characteristics and spot sign on CTA to assist clinical judgment. The spot sign is an accepted independent predictor of active hemorrhage and is used in both secondary intracerebral hemorrhage and the process of surgical assessment for hemorrhagic risk in patients with ischemic stroke. Spot sign predicts patients at high risk for hematoma expansion.
血肿扩大（HE）约发生于三分之一的脑出血患者中，导致高死亡率和高发病率。目前，血肿内的对比剂外渗，在 CT 血管造影（CTA）上被称为斑点征，已被确定为早期血肿扩大的强独立预测因子。过去的研究表明，斑点征是一个动态实体，提示有活跃性出血。此外，为了提高斑点征预测 HE 的准确性，使用 CTA 或动态 CTA 上观察到的斑点参数对其进行定量。此外，与简单的标准化斑点征检测相比，多期 CTA 和动态 CTA 上检测到的斑点征在最近的研究中显示出更高的敏感性和特异性。基于斑点征，一些新的方法如漏出征和对比剂外渗率被探索出来，以结合临床特征和 CTA 上的斑点征来重新定义 HE 预测，以辅助临床判断。斑点征是活跃性出血的公认独立预测因子，用于继发性脑出血和缺血性脑卒中患者的手术评估中出血风险的过程。斑点征预测血肿扩大风险高的患者。
