Non-contrast CT markers of intracerebral hemorrhage expansion: The influence of onset-to-CT time

作者全名："Morotti, Andrea; Li, Qi; Mazzoleni, Valentina; Nawabi, Jawed; Schlunk, Frieder; Mazzacane, Federico; Busto, Giorgio; Scola, Elisa; Brancaleoni, Laura; Giacomozzi, Sebastiano; Simonetti, Luigi; Laudisi, Michele; Cavallini, Anna; Zini, Andrea; Casetta, Ilaria; Fainardi, Enrico; Dowlatshahi, Dar; Padovani, Alessandro; Arba, Francesco"

作者地址："[Morotti, Andrea; Padovani, Alessandro] ASST Spedali Civili, Neurol Unit, Dept Neurol Sci & Vis, Ple Spedali Civili 1, I-25100 Brescia, Italy; [Li, Qi] Anhui Med Univ, Affiliated Hosp 2, Dept Neurol, Hefei, Peoples R China; [Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China; [Mazzoleni, Valentina; Padovani, Alessandro] Univ Brescia, Dept Clin & Expt Sci, Neurol Unit, Owensboro, Italy; [Nawabi, Jawed] Charite Univ Med Berlin, Campus Mitte, Berlin Inst Hlth, Dept Radiol CCM, Berlin, Germany; [Nawabi, Jawed; Schlunk, Frieder] Humboldt Univ, Berlin, Germany; [Nawabi, Jawed; Schlunk, Frieder] Free Univ Berlin, Berlin, Germany; [Nawabi, Jawed; Schlunk, Frieder] Berlin Inst Hlth BIH, BIH Biomed Innovat Acad, Berlin, Germany; [Schlunk, Frieder] Charite Univ Med Berlin, Dept Neuroradiol, Berlin, Germany; [Mazzacane, Federico] Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy; [Mazzacane, Federico; Cavallini, Anna] IRCCS Fdn Mondino, UC Malattie Cerebrovasc & Stroke Unit, Pavia, Italy; [Busto, Giorgio; Scola, Elisa] Careggi Univ Hosp, Dept Radiol, Neuroradiol Unit, Florence, Italy; [Brancaleoni, Laura; Giacomozzi, Sebastiano; Zini, Andrea] Osped Maggiore Bologna, UOC Neurol & Rete Stroke Metropolitana, IRCCS Ist Sci Neurol Bologna, Bologna, Italy; [Simonetti, Luigi] Osped Maggiore Bologna, UO SSI Neuroradiol, IRCCS Ist Sci Neurol Bologna, Bologna, Italy; [Laudisi, Michele; Casetta, Ilaria] Univ Ferrara, Dipartimento Sci Biomed & Chirurg Specialist, Clin Neurol, Ferrara, Italy; [Laudisi, Michele; Casetta, Ilaria] Osped Univ S Anna, Ferrara, Italy; [Fainardi, Enrico] Univ Florence, Dept Expt & Clin Biomed Sci, Neuroradiol Unit, Florence, Italy; [Dowlatshahi, Dar] Univ Ottawa, Ottawa Hosp Res Inst, Div Neurol, Dept Med, Ottawa, ON, Canada; [Arba, Francesco] AOU Careggi, Stroke Unit, Florence, Italy"

通信作者："Morotti, A (通讯作者)，ASST Spedali Civili, Neurol Unit, Dept Neurol Sci & Vis, Ple Spedali Civili 1, I-25100 Brescia, Italy."

来源：INTERNATIONAL JOURNAL OF STROKE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000898928300001

JCR分区：Q1

影响因子：6.3

年份：2023

卷号：　

期号：　

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结束页：　

文献类型：Article; Early Access

关键词：Stroke; intracerebral hemorrhage; computed tomography; time

摘要："Background: Hematoma expansion (HE) is an appealing therapeutic target in intracerebral hemorrhage (ICH) and non-contrast computed tomography (NCCT) features are promising predictors of HE. Aims: We investigated whether onset-to-CT time influences the diagnostic performance of NCCT markers for HE. Methods: Retrospective multicentre analysis of patients with primary ICH. The following NCCT markers were analyzed: hypodensities, heterogeneous density, blend sign, and irregular shape. HE was defined as growth > 6 mL and/or > 33%. We calculated the sensitivity, specificity, positive, and negative predictive values (PPVs and NPVs) of NCCT markers for HE, stratified by onset-to-CT time (<2 h, 2-4 h, 4-6 h, >6 h). Results: We included 1135 patients (median age 69, 53% males), of whom 307 (27%) experienced HE. Overall hypodensities had the highest sensitivity (0.68) and blend sign the highest specificity (0.87) for HE. Hypodensities were more common and had higher sensitivity (0.80) in patients with imaging within 2 h. The same result was observed for heterogeneous density, whereas irregular shape had a similar prevalence across time strata and higher sensitivity (0.79) beyond 6 h from onset. The frequency of blend sign increased with longer onset-to-CT time, whereas its specificity declined after 6 h from onset. Conclusion: The diagnostic performance of NCCT markers is influenced by imaging time. Hypodensities identified four out of five patients with HE within 2 h from onset, whereas irregular shape performed better in late presenters. Our findings may improve the use of NCCT markers in future studies and trials targeting HE."

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