Institute of Clinical Radiology, University Hospital of Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany.
Institute of Neuroradiology, University Hospital of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany.
Acta Neurochir (Wien). 2018 Aug;160(8):1663-1670. doi: 10.1007/s00701-018-3605-x. Epub 2018 Jun 26.
Besides the established spot sign in computed tomography angiography (CTA), recently investigated imaging predictors of hematoma growth in noncontrast computed tomography (NCCT) suggest great potential for outcome prediction in patients with intracerebral hemorrhage (ICH). Secondary hematoma growth is an appealing target for therapeutic interventions because in contrast to other determined factors, it is potentially modifiable. Even more initial therapy studies failed to demonstrate clear therapeutic benefits, there is a need for an effective patient selection using imaging markers to identify patients at risk for poor outcome and thereby tailor individual treatments for every patient. Hence, this review gives an overview about the current literature on NCCT imaging markers for neurological outcome prediction and aims to clarify the association with the established spot sign. Moreover, it demonstrates the clinical impact of these parameters and gives a roadmap for future imaging research in patients with intracerebral hemorrhage.
除了在计算机断层血管造影(CTA)中已经确立的局部征象外,最近研究的非对比计算机断层扫描(NCCT)中血肿增长的影像学预测因子表明,其对颅内出血(ICH)患者的预后预测具有巨大潜力。继发性血肿增长是治疗干预的一个有吸引力的目标,因为与其他确定的因素相比,它是潜在可改变的。即使最初的治疗研究未能证明明确的治疗益处,也需要使用影像学标志物进行有效的患者选择,以识别预后不良的风险患者,从而为每位患者量身定制个体化治疗。因此,本综述概述了关于 NCCT 影像学标志物用于神经预后预测的最新文献,并旨在阐明其与已确立的局部征象的关联。此外,它还展示了这些参数的临床影响,并为脑出血患者的未来影像学研究提供了路线图。