Scholarlink

Objectives <p>To evaluate the predictive value of two radiological markers, the spot sign and leakage sign, for spontaneous intracranial hematoma expansion and their association with clinical outcomes, including neurological deterioration and in-hospital mortality.</p> Materials &amp; methods <p>This prospective single-center study included 94 adult patients with spontaneous intraparenchymal hemorrhagic stroke, confirmed by non-enhanced CT (NECT) and contrast-enhanced CT (CECT) in the arterial phase. Hematoma volumes and spot/leakage signs were assessed using standardized imaging protocols and analyzed by two blinded neuroradiologists. Clinical and radiological data were evaluated using multivariate analyses, with survival outcomes compared via Kaplan–Meier curves. Statistical significance was set at p ≤ 0.05.</p> Results <p>Among 94 patients, hematoma expansion occurred in 42%, neurological deterioration in 15.5%, and mortality in 39.4%. The leakage sign was the strongest independent predictor of hematoma expansion (OR: 9.27, 95% CI: 2.95–29.20), neurological deterioration (OR: 26.67, 95% CI: 1.62–47.39), and mortality (OR: 7.56, 95% CI: 2.97–19.25). The spot and leakage signs demonstrated high specificity for predicting outcomes, with the leakage sign showing greater sensitivity for hematoma expansion. Patients with a positive leakage sign had significantly lower median survival (6&#xa0;days) compared to those with a positive spot sign alone (54&#xa0;days) or no signs (110&#xa0;days, p &lt; 0.001).</p> Conclusion <p>The leakage sign demonstrated greater sensitivity and comparable specificity to the spot sign for predicting hematoma expansion. Both signs were associated with neurological deterioration and in-hospital mortality, with the leakage sign showing a stronger predictive value.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Comparative assessment of the spot sign and leakage sign as predictive factors for spontaneous intracranial hematoma expansion

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月12日

查看全文
  • María Del Carmen González Domínguez,
  • Roberto Fornell-Pérez,
  • Ernesto Santana Suárez,
  • Diego Riol Sancho,
  • Elisabet González Domínguez,
  • Juan Francisco Loro-Ferrer

摘要

Objectives

To evaluate the predictive value of two radiological markers, the spot sign and leakage sign, for spontaneous intracranial hematoma expansion and their association with clinical outcomes, including neurological deterioration and in-hospital mortality.

Materials & methods

This prospective single-center study included 94 adult patients with spontaneous intraparenchymal hemorrhagic stroke, confirmed by non-enhanced CT (NECT) and contrast-enhanced CT (CECT) in the arterial phase. Hematoma volumes and spot/leakage signs were assessed using standardized imaging protocols and analyzed by two blinded neuroradiologists. Clinical and radiological data were evaluated using multivariate analyses, with survival outcomes compared via Kaplan–Meier curves. Statistical significance was set at p ≤ 0.05.

Results

Among 94 patients, hematoma expansion occurred in 42%, neurological deterioration in 15.5%, and mortality in 39.4%. The leakage sign was the strongest independent predictor of hematoma expansion (OR: 9.27, 95% CI: 2.95–29.20), neurological deterioration (OR: 26.67, 95% CI: 1.62–47.39), and mortality (OR: 7.56, 95% CI: 2.97–19.25). The spot and leakage signs demonstrated high specificity for predicting outcomes, with the leakage sign showing greater sensitivity for hematoma expansion. Patients with a positive leakage sign had significantly lower median survival (6 days) compared to those with a positive spot sign alone (54 days) or no signs (110 days, p < 0.001).

Conclusion

The leakage sign demonstrated greater sensitivity and comparable specificity to the spot sign for predicting hematoma expansion. Both signs were associated with neurological deterioration and in-hospital mortality, with the leakage sign showing a stronger predictive value.

Graphical Abstract