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@proceedings{1792201,
author = {Sultan, Abdulaziz Al and Teleg, Ericka and Horn, MacKenzie and Ojha, Piyush and Machová, Linda and Marzoughi, Sina and Ohara, Tomoyuki and Banerjee, Ankur and Kulkarni, Girish and Bobyn, Amy and Neweduk, Anneliese and Horn, Kennedy and RodriguezandLuna, David and Goyal, Mayank and Menon, Bijoy K and Demchuk, Andrew M},
booktitle = {INTERNATIONAL STROKE CONFERENCE 2020},
title = {Ongoing Leakage Revealed by Second Phase Spot Sign Volume Expansion in Multi-Phase Computed Tomography Angiography Strongly Predicts Intracranial Hemorrhage Growth},
url = {https://www.ahajournals.org/doi/10.1161/str.51.suppl_1.77},
year = {2020}
}
TY - CONF
ID - 1792201
AU - Sultan, Abdulaziz Al - Teleg, Ericka - Horn, MacKenzie - Ojha, Piyush - Machová, Linda - Marzoughi, Sina - Ohara, Tomoyuki - Banerjee, Ankur - Kulkarni, Girish - Bobyn, Amy - Neweduk, Anneliese - Horn, Kennedy - Rodriguez-Luna, David - Goyal, Mayank - Menon, Bijoy K - Demchuk, Andrew M
PY - 2020
TI - Ongoing Leakage Revealed by Second Phase Spot Sign Volume Expansion in Multi-Phase Computed Tomography Angiography Strongly Predicts Intracranial Hemorrhage Growth
UR - https://www.ahajournals.org/doi/10.1161/str.51.suppl_1.77
N2 - Background: CTA spot sign is a predictor of intracerebral hemorrhage (ICH) expansion. This sign can fluctuate in appearance, volume, and timing. Multiphase CTA (mCTA) can identify spot sign through 3 time-resolved images. We sought to identify a novel predictor of follow up total hematoma expansion using mCTA. Methods: This cohort study included patients with ICH between 2012-2019. Quantomo software was used to measure total hematoma volume (ml) from baseline CT & follow-up CT/MRI blinded to spot sign in 3 mCTA phases. Spot sign expansion was calculated by subtracting 1st phase spot sign volume from 2nd phase spot sign volume measured in microliters. Results: 199 patients [63% male, mean age 69 years, median NIHSS 11, IQR 6-20] were included. Median baseline ICH volume was 16.1 ml (IQR 5-29.9 ml). Amongst all three mCTA phases, spot sign was best detected on the 2nd phase (23% vs 17.5% 1st phase vs 22% 3rd phase). In multivariable regression, spot sign expansion was significantly associated with follow up total hematoma expansion (OR: 1.03 per microliter of spot sign expansion, p=0.01). Figure 1 shows the predicted total hematoma expansion by spot sign expansion. mCTA spot sign had a higher sensitivity for predicting total hematoma volume expansion than single-phase CTA (reported in meta-analysis of 14 studies), 86% vs 53%, respectively, while both having similar specificity, 87% vs 88%, respectively. Conclusion: Spot sign expansion on mCTA is a novel predictor of total hematoma expansion and could be used to select patients for immediate therapeutic intervention in future clinical trials. Using mCTA improves sensitivity while preserving specificity over single-phase CTA.
ER -
SULTAN, Abdulaziz Al, Ericka TELEG, MacKenzie HORN, Piyush OJHA, Linda MACHOVÁ, Sina MARZOUGHI, Tomoyuki OHARA, Ankur BANERJEE, Girish KULKARNI, Amy BOBYN, Anneliese NEWEDUK, Kennedy HORN, David RODRIGUEZ-LUNA, Mayank GOYAL, Bijoy K MENON a Andrew M DEMCHUK. Ongoing Leakage Revealed by Second Phase Spot Sign Volume Expansion in Multi-Phase Computed Tomography Angiography Strongly Predicts Intracranial Hemorrhage Growth. In \textit{INTERNATIONAL STROKE CONFERENCE 2020}. 2020.
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