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Erschienen in: European Radiology 10/2018

19.04.2018 | Neuro

Iodine concentration: a new, important characteristic of the spot sign that predicts haematoma expansion

verfasst von: Fan Fu, Shengjun Sun, Liping Liu, Jianying Li, Yaping Su, Yingying Li

Erschienen in: European Radiology | Ausgabe 10/2018

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Abstract

Objectives

The computed tomography angiography (CTA) spot sign is a validated predictor of haematoma expansion (HE) in spontaneous intracerebral haemorrhage (SICH). We investigated whether defining the iodine concentration (IC) inside the spot sign and the haematoma on Gemstone spectral imaging (GSI) would improve its sensitivity and specificity for predicting HE.

Methods

From 2014 to 2016, we prospectively enrolled 65 SICH patients who underwent single-phase spectral CTA within 6 h. Logistic regression was performed to assess the risk factors for HE. The predictive performance of individual spot sign characteristics was examined via receiver operating characteristic (ROC) analysis.

Results

The spot sign was detected in 46.1% (30/65) of patients. ROC analysis indicated that IC inside the spot sign had the greatest area under the ROC curve for HE (0.858; 95% confidence interval, 0.727–0.989; p = 0.003). Multivariate analysis found that spot sign with higher IC (i.e. IC > 7.82 100 μg/ml) was an independent predictor of HE (odds ratio = 34.27; 95% confidence interval, 5.608–209.41; p < 0.001) with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 0.81, 0.75, 0.90 and 0.60, respectively; while the spot sign showed sensitivity, specificity, PPV and NPV of 0.81, 0.79, 0.73 and 0.86. Logistic regression analysis indicated that the IC in haematomas was independently associated with HE (odds ratio = 1.525; 95% confidence interval, 1.041–2.235; p = 0.030).

Conclusions

ICs in haematoma and in spot sign were all independently associated with HE. IC analysis in spectral imaging may help to identify SICH patients for targeted haemostatic therapy.

Key Points

• Iodine concentration in spot sign and haematoma can predict haematoma expansion
• Spectral imaging could measure the IC inside the spot sign and haematoma
• IC in spot sign improved the positive predictive value (PPV) cf. CTA
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Metadaten
Titel
Iodine concentration: a new, important characteristic of the spot sign that predicts haematoma expansion
verfasst von
Fan Fu
Shengjun Sun
Liping Liu
Jianying Li
Yaping Su
Yingying Li
Publikationsdatum
19.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5415-1

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