Comparison Of Satellite Sign And Island Sign In Patients With Intracerebral Hemorrhage

PART ONE THE SLICE SCORE: COMPARISION OF SATELLITE SIGN AND ISLAND SIGN IN PREDICTING HEAMTOMA GROWTH AND POOR OUTCOME IN PATIENTS WITH PRIMARY INTRACEREBRAL HEMORRHAGEBackground and Purpose Satellite sign(SS)and island sign(IS)are novel noncontrast computed tomography(CT)predictors of hematoma growth.The aim of this study was to compare diagnostic performance of IS and SS in predicting hematoma growth and functional outcome in patients with intracerebral hemorrhage(ICH).Materials and Methods The study included patients with ICH who underwent baseline CT scan within 6 hours of symptom onset and follow-up CT scan within 36 hours after initial CT between July 2012 and April 2017.Sensitivity,specificity,positive predictive value,and negative predictive value of IS and SS in predicting hematoma growth and functional outcome were assessed.Accuracy of the 2 signs in predicting hematoma growth and functional outcome was analyzed using receiver operating characteristic analysis.Association between the presence of IS and SS and ICH growth was assessed using multivariate logistic regression.Results Of 307 patients with ICH,IS was observed in 46 patients(15.0%),and SS was observed in 151 patients(49.2%).Rates of hematoma growth were40.4% in SS+ patients,91.3% in IS+ patients,18.4% in SS-IS-patients,21.1% in SS+IS-patients,100% in SS-IS+ patients,and 90.5% in SS+IS+patients.After adjusting for potential confounders,IS remained an independent predictor for hematoma growth and poor functional outcome.The area under the curve of IS was significantly larger than the area under the curve of SS in predicting hematoma growth(P = 0.001).Conclusions IS seems to be an optimal shape irregularity imaging marker for predicting hematoma growth and functional outcome in patients with ICH.PART TWO HEMATOMA VENTRICLE DISTANCE ON COMPUTED TOMOGRAPHY PREDICTS POOR OUTCOME IN INTRACEREBRAL HEMORRHAGEBackground and Purpose Intracerebral hemorrhage(ICH)is the most severe and devastating stroke subtype,with an up to 40% mortality at 30 days.Baseline hematoma volume,infratentorial location and the presence of intraventricular hemorrhage(IVH)are independent predictors of functional outcome.Among them,the hematoma volume is the most powerful predictor of poor functional outcome.We aim to investigate the relationship between hematoma ventricle distance(HVD)and clinical outcome in patients with intracerebral hemorrhage(ICH).Materials and Methods We prospectively enrolled consecutive patients with ICH in a tertiary academic hospital between July 2011 and April 2018.We retrospectively reviewed images for all patients receiving a computed tomography(CT)within 6 hours after onset of symptoms and at least one follow-up CT scan within 36 hours.The minimum distance of hematoma border to nearest ventricle was measured as HVD.Youden index was used to evaluate the cutoff of HVD predicting functional outcome.Logistic regression model was used to assess the HVD data and clinical poor outcome(modified Rankin Scale 4-6)at 90 days.Results A total of 325 patients were included in our final analysis.The median HVD was 2.4 mm(interquartile range,0-5.7mm)and 119(36.6%)patients had poor functional outcome at 3months.After adjusting for age,admission Glasgow coma scale,intraventricular hemorrhage,baseline ICH volume,admission systolic blood pressure,hypertension,HVD≤2.5mm was associated with increased odds of clinical poor outcome(odds ratio,3.59,[95%CI=1.72-7.50];P =0.001)in multivariable logistic regression analysis.Conclusions HVD could sever as a novel and useful addition to predict ICH prognosis.