Distribution and predictive performance of the temporal phase of dynamic spot sign appearance in acute intracerebral hemorrhage

• DOI: 10.1371/journal.pone.0236196
• Publication Date: 2020-08-06T18:54:37Z
• Authors: Hee Sahng Chung; Santanu Chakraborty; Michael Reaume; Vignan Yogendrakumar; Matthew J. Hogan; Dylan Blacquiere; Grant Stotts; Michel Shamy; Richard I. Aviv; Dar Dowlatshahi
• Keywords: Extravasation; Bright spot

Background Dynamic CT angiography (dCTA) contrast extravasation, known as the "dynamic spot sign", can predict hematoma expansion (HE) in intracerebral hemorrhage (ICH). Recent reports suggest phase of sign appearance is related to magnitude HE. We used dCTA explore association between and HE, clinical outcome, extravasation rates. Methods assessed consecutive patients who presented with primary ICH within 4.5 hours from symptom onset underwent a standardized protocol were positive. The independent variable was appearance. outcome significant HE (either 6 mL or 33% growth). Secondary outcomes included total absolute mortality, discharge mRS. Mann-Whitney U, Fisher's exact test, logistic regression used, appropriate. Results Of 35 signs, 27/35 (77%) appeared arterial 8/35 (23%) venous phase. Thirty had follow-up scans. Significant seen 14/23 (60.87%) 3/7 (42.86%) cohorts, respectively (p = 0.67). sensitivity specificity predicting 82% 31% for 18% 69% phase, respectively. There non-significant trend towards greater in-hospital mRS 4–6 cohort. Arterial signs demonstrated higher median rate (0.137 mL/min) compared (0.109 mL/min). Conclusion Our exploratory analyses that may be more likely associated poorer prognosis ICH. This rates signs. However, further studies larger sample sizes are warranted confirm findings.