Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Medical Imaging
  4. Volume 20, Issue 1
  5. Article
Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
file format pdf download PDF
side by side viewer icon HTML

Abstract

Background

Controversies still exist regarding the mechanism formation of the blend sign, defined as hypodensity and hyperdensity regions, in Intracerebral Hemorrhage (ICH), and which region associated with bleeding remains unknown. Spot sign is an independent predictor of hematoma expansion (HE) and indicates persistent bleeding focus in the hematoma. Here, we sought to establish the relationship between the spot sign and the blend sign to gain insights into the formation of the blend sign.

Methods

Patients were categorized based on the spot sign location within the blend sign in patients with ICH from 2018 to 2023. subjects with a spot sign in the hypodensity region of the blend sign (hypo-spot sign group); subjects with a spot sign in the hyperdensity region of the blend sign (hyper-spot sign group). Subsequently, patients were stratified into two groups based on the presence or absence of HE. Also, we analyzed the relationship between the spot sign and the blend sign, as well as the association between the blend sign and HE.

Results

A total of 205 patients were included, including 190 patients (92.7%) who had the spot sign in the hyper-spot sign and 15 patients (7.3%) who had the spot sign in the hypo-spot sign. HE was observed in 60 patients (29.3%), 59 (98.3%) of whom had the spot sign detected in the hyper-spot sign, while only one (1.7%) had the spot sign in the hypo-spot sign. Univariate logistic regression analysis revealed that the hyper-spot sign group (6.305, 1.810–49.072; < 0.05) was an independent predictor of HE.

Conclusion

The hyperdensity area of the blend sign may represent fresh bleeding in ICH rather than the hypodensity area.

Trial Registration

ClinicalTrials.gov, NCT05548530. Registered on September 21, 2022, Prognostic Analysis of Different Treatment Options for Cerebral Hemorrhage-Full Text View - ClinicalTrials.gov “retrospectively registered.”

© 2024 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Loading

Article metrics loading...

/content/journals/cmir/10.2174/0115734056310498241017052529
2024-01-01
2025-04-21

  • From This Site

    /content/journals/cmir/10.2174/0115734056310498241017052529
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
The full text of this item is not currently available.

References

  1. QianZ. Chinese stroke association guidelines for clinical management of cerebrovascular diseasesChin J Stroke202318910141023
     [Google Scholar]
  2. LiQ. ShenY.Q. XieX.F. XueM.Z. CaoD. YangW.S. LiR. DengL. WeiM. LvF.J. WuG.F. TangZ.P. XieP. Expansion-Prone hematoma: Defining a population at high risk of hematoma growth and poor outcome.Neurocrit. Care201930360160810.1007/s12028‑018‑0644‑330430380
     [Google Scholar]
  3. MorottiA. BoulouisG. CharidimouA. PoliL. CostaP. GiuliV. LeuciE. MazzacaneF. BustoG. ArbaF. BrancaleoniL. GiacomozziS. SimonettiL. LaudisiM. CavalliniA. GambaM. MagoniM. CornaliC. FontanellaM.M. WarrenA.D. GurolE.M. ViswanathanA. GasparottiR. CasettaI. FainardiE. ZiniA. PezziniA. PadovaniA. GreenbergS.M. RosandJ. GoldsteinJ.N. Imaging markers of intracerebral hemorrhage expansion in patients with unclear symptom onset IJS202217910131020
     [Google Scholar]
  4. LiQ. DongF. WangQ. XuF. ZhangM. A model comprising the blend sign and black hole sign shows good performance for predicting early intracerebral haemorrhage expansion: A comprehensive evaluation of CT features.Eur. Radiol.202131129131913810.1007/s00330‑021‑08061‑y34109487
     [Google Scholar]
  5. WuG. ShenZ. WangL. SunS. LuoJ. MaoY. Post-operative re-bleeding in patients with hypertensive ICH is closely associated with the CT blend sign.BMC Neurol.201717113110.1186/s12883‑017‑0910‑628683728
     [Google Scholar]
  6. YangX. ZhuY. ZhangL. WangL. MaoY. LiY. LuoJ. WuG. The initial CT blend sign is not associated with poor patient outcomes after stereotactic minimally invasive surgery.BMC Neurol.202121116010.1186/s12883‑021‑02181‑033858371
     [Google Scholar]
  7. LiQ. ZhangG. HuangY.J. DongM.X. LvF.J. WeiX. ChenJ.J. ZhangL.J. QinX.Y. XieP. Blend Sign on Computed Tomography.Stroke20154682119212310.1161/STROKEAHA.115.00918526089330
     [Google Scholar]
  8. LiY. RenS. WangL. MaoY. WuG. LiQ. TangZ. Is the CT blend sign composed of two parts of blood with different age?Neurocrit. Care202135236737810.1007/s12028‑020‑01165‑133403585
     [Google Scholar]
  9. PeetersM.T.J. KortK.J.D. HoubenR. HennemanW.J.P. OostenbruggeR.J. StaalsJ. PostmaA.A. Dual-EnergyC.T. Dual-Energy CT Angiography improves accuracy of spot sign for predicting hematoma expansion in intracerebral hemorrhage.J. Stroke2021231829010.5853/jos.2020.0353133600705
     [Google Scholar]
  10. SpornsP.B. KemmlingA. SchwakeM. MinnerupJ. NawabiJ. BroocksG. WildgruberM. FiehlerJ. HeindelW. HanningU. Triage of 5 noncontrast computed tomography markers and spot sign for outcome prediction after intracerebral hemorrhage.Stroke201849102317232210.1161/STROKEAHA.118.02162530355120
     [Google Scholar]
  11. WangL. ZhangL. MaoY. LiY. WuG. LiQ. Regular-shaped hematomas predict a favorable outcome in patients with hypertensive intracerebral hemorrhage following stereotactic minimally invasive surgery.Neurocrit. Care202134125927010.1007/s12028‑020‑00996‑232462410
     [Google Scholar]
  12. BrouwersH.B. GoldsteinJ.N. RomeroJ.M. RosandJ. Clinical applications of the computed tomography angiography spot sign in acute intracerebral hemorrhage: A review.Stroke201243123427343210.1161/STROKEAHA.112.66400323132779
     [Google Scholar]
  13. YuanL. ShenY.Q. XieX.F. YangW.S. LiR. DengL. LiQ. XieP. Combination of ultra-early hematoma growth and blend sign for predicting hematoma expansion and functional outcome.Clin. Neurol. Neurosurg.202018910562510.1016/j.clineuro.2019.10562531835077
     [Google Scholar]
  14. WuQ. Wang Li kun, Ren Si Ying,Wu Guo feng, Value of blend sign combined with spot sign for predicting hematoma expansion in intracerebral hemorrhage patients.Chin J Geriatr Heart Brain Vessel Dis20212308828831
     [Google Scholar]
  15. YamaguchiS. YoshidaM. IwanagaM. Hematoma expansion caused by trapped cerebrospinal fluid in subacute phase intracerebral hemorrhage: A case report.Surg. Neurol. Int.2022138610.25259/SNI_955_202135399899
     [Google Scholar]
  16. WadaR. AvivR.I. FoxA.J. SahlasD.J. GladstoneD.J. TomlinsonG. SymonsS.P. CT angiography “spot sign” predicts hematoma expansion in acute intracerebral hemorrhage.Stroke20073841257126210.1161/01.STR.0000259633.59404.f317322083
     [Google Scholar]
  17. Morais FilhoA.B. RegoT.L.H. MendonçaL.L. AlmeidaS.S. NóbregaM.L. PalmieriT.O. GiustinaG.Z.D. MeloJ.P. PinheiroF.I. GuzenF.P. The physiopathology of spontaneous hemorrhagic stroke: A systematic review.Rev. Neurosci.202132663165810.1515/revneuro‑2020‑013133594841
     [Google Scholar]
  18. MorottiA. BoulouisG. DowlatshahiD. LiQ. ShamyM. SalmanR.A-S. RosandJ. CordonnierC. GoldsteinJ.N. CharidimouA. Intracerebral haemorrhage expansion: Definitions, predictors, and prevention.Lancet Neurol.202322215917110.1016/S1474‑4422(22)00338‑636309041
     [Google Scholar]
  19. LeiC. GengJ. QiZ. ZhongL. Different criteria for defining “spot sign” in intracerebral hemorrhage show different abilities to predict hematoma expansion and clinical outcomes: A systematic review and meta-analysis.Neurosurg. Rev.20214463059306810.1007/s10143‑021‑01503‑733608829
     [Google Scholar]
  20. MiyaharaM. NodaR. YamaguchiS. TamaiY. InoueM. OkamotoK. HaraT. New prediction score for hematoma expansion and neurological deterioration after spontaneous intracerebral hemorrhage: A Hospital-based retrospective cohort Study. official journal of National Stroke Association,20182792543255010.1016/j.jstrokecerebrovasdis.2018.05.018
     [Google Scholar]
  21. SpornsP.B. SchwakeM. KemmlingA. MinnerupJ. SchwindtW. NiederstadtT. SchmidtR. HanningU. Comparison of spot sign, blend sign and black hole sign for outcome prediction in patients with intracerebral hemorrhage.J. Stroke201719333333910.5853/jos.2016.0206129037015
     [Google Scholar]
  22. ToyodaK. KogaM. Controlling blood pressure soon after intracerebral hemorrhage: The SAMURAI-ICH Study and its successorsOfficial journal of the Japanese Society of Hypertension20224544583590
     [Google Scholar]
  23. SchreiberF. KuschelJ.N. KlaiM. ChahemC. ArndtP. PerosaV. AssmannA. DörnerM. LuchtmannM. MeuthS.G. VielhaberS. HenneickeS. SchreiberS. Blend sign and haemorrhage location and volume predict late recurrence and mortality in intracerebral haemorrhage patients.J. Clin. Med.20231219613110.3390/jcm1219613137834774
     [Google Scholar]
/content/journals/cmir/10.2174/0115734056310498241017052529
Loading
Is the Hyperdensity Areas of the CT Blend Sign Associated with the Fresh Bleeding in Intracerebral Hemorrhage?
Curr. Med. Imaging 20, e15734056310498 (2024); https://doi.org/10.2174/0115734056310498241017052529
/content/journals/cmir/10.2174/0115734056310498241017052529
/content/journals/cmir/10.2174/0115734056310498241017052529
Loading

Data & Media loading...


  • Article Type:     Research Article
Keyword(s): Blend sign; Hematoma expansion; Hyperdensity; Intracerebral hemorrhage; Non-contrast-enhanced computed tomography; Spot sign

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test