The Progress In Imaging Studies Of Early Hematoma Expansion In Primary Intracerebral Hemorrhage

Hematoma expansion(HE)occurs in approximately 33% of patients with primary intracerebral hemorrhage and leads to high rates of mortality and morbidity.Currently,contrast extravasation within hematoma,termed the spot sign on computed tomography angiography(CTA),has been identified as a strong independent predictor of early HE.Past studies indicate that the spot sign is a dynamic entity and is indicative of active hemorrhage.Furthermore,to enhance the spot sign's accuracy of predicting HE,we quantify the spot parameters observed on CTA or dynamic CTA.In addition,spot signs detected on multiphase CTA and dynamic CTA are shown to have higher sensitivity and specificity when compared with simple standardized spot sign detection in recent studies.Based on the spot sign,novel methods such as leakage sign and rate of contrast extravasation were explored for predicting HE.Combined with the clinical characteristics and the spot sign on CTA,it has been proposed these years that the non-uniform density on the non-contrast CT,like hypodensity sign,blend sign,black hole sign,satellite sign,island sign and other signs can alsopredict early HE and are more widespread.In recent years,in order to better detect patients with potential early HE,HE predictive scoring system is also a research hotspot and aids to stratify risk.This paper mainly discusses the predictive value of the above signs and predictive scoring system on HE,hoping to better assist clinicians to take early intervention treatment,so as to improve the clinical outcome and prognosis.