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  • Noncontrast CT better...

Noncontrast CT better alternative to CTA for predicting Hematoma expansion in ICH

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-01-20T10:00:39+05:30  |  Updated On 20 Jan 2023 12:12 PM IST
Noncontrast CT better alternative to CTA for predicting Hematoma expansion in ICH
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A new study found that in intracerebral hemorrhages for identifying hematoma expansion non contrast computed tomography hypodensities are better alternatives to CTA spot signs as non-contrast CT hypodensities significantly add value and predict hematoma expansion.

The study results are published in the journal Stroke.

Previous literature shows that in intracerebral hemorrhage non-contrast computed tomography hypodensities are a better predictor of hematoma expansion (HE) and a possible alternative to the computed tomography angiography (CTA) spot sign but there is uncertainty on the added value to available prediction models. Hence researchers conducted a multicenter study to investigate whether the inclusion of hypodensities improves the prediction of HE and compared their added value over the spot sign.

Also Read: Lower mortality rates seen with pharmaco-invasive strategy than late primary PCI in STEMI patients

A multicenter, retrospective analysis was carried out at 8 university hospitals on patients admitted for primary spontaneous intracerebral hemorrhage.

Boston

1994-2015

Prospective

Hamilton, Canada

2010-2016

Retrospective

Berlin, Germany

2014-2019

Retrospective

Chongqing, China

2011-2015

Retrospective

Pavia, Italy

2017-2019

Prospective

Ferrara, Italy

2010-2019

Retrospective

Brescia, Italy

2020-2021

Retrospective

Bologna, Italy

2015-2019

Retrospective

Logistic regression analysis was used to explore the predictors of HE like the hematoma growth >6 mL and/or >33% from baseline to follow-up imaging. The discrimination of a simple prediction model for HE based on 4 predictors (antiplatelet and anticoagulant treatment, baseline intracerebral hemorrhage volume, and onset-to-imaging time) before and after the inclusion of non-contrast computed tomography hypodensities, were compared using the receiver operating characteristic curve and De Long test for the area under the curve comparison.

Also Read: Hypertension and hyperglycemia additively increase CVD risk, relative contribution attenuated in presence of either: JAHA

Key findings:

  • A total of 2465 subjects were included, of whom 664 (26.9%) had HE and 1085 (44.0%) had hypodensities.
  • After adjustment for confounders in logistic regression, hypodensities were independently associated with HE.
  • The discrimination of the 4 predictors model improved with the inclusion of non-contrast computed tomography hypodensities.
  • The added value of hypodensities was statistically significant but the addition of the CTA spot sign did not provide significant discrimination improvement in the subgroup of CTA patients (n=895, 36.3%).

Thus, non-contrast computed tomography hypodensities can be used to stratify the risk of HE with good discrimination without CTA.

Further reading: Morotti A, Boulouis G, Nawabi J, et al. Using Noncontrast Computed Tomography to Improve Prediction of Intracerebral Hemorrhage Expansion [published online ahead of print, 2023 Jan 9]. Stroke. 2023;10.1161/STROKEAHA.122.041302. doi: 10.1161/STROKEAHA.122.041302

StrokeVascular diseasesAndrea MorottiComputed Tomography
Source : Stroke
Dr.Niharika Harsha B
Dr.Niharika Harsha B

    BDS, MDS

    Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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