Abstract W P247: Dynamic Characterization of CT Angiographic Spot Sign
Background and purpose: Standard (static) CT angiography is used to identify the intracerebral hemorrhage (ICH) spot sign. We used dynamic CT-angiography to describe spot sign characteristics and measurement parameters over 60-seconds of image acquisition.
Methods: We prospectively collected consecutive patients with acute ICH presenting within 6 hours of symptom onset who underwent whole brain dynamic CT-angiography (dCTA). Spot parameters (earliest appearance, duration, Maximum Hounsfield unit (HU), time to maximum HU, time to spot diagnosis (based on HU>100 or >120) and spot volume) and hematoma volumes were measured using volumetric analysis software.
Result: We enrolled 34 patients: three were excluded due to secondary causes of ICH. In the 31 patients with primary ICH, there were 13 males with median age 70 and baseline hematoma volume 33 ml. In our series, 13 patients (42 %) had positive dCTA spot sign. The spot was visualized as an expanding 3-dimensional structure that temporally evolved in its morphology over the scanning period. Median time to spot appearance was 21s (range 15-35 seconds). This method allowed tracking spots where they continued until end of venous phase (persistent leak) with median duration of 39s (range 25-45 seconds). The median maximum HU was 204, and median time to maximum HU was 30.8s. Median time to spot diagnosis was 20.8s using either the HU 100 or 120 definitions.
Conclusion: Dynamic CT Angiography allows a 3-dimensional assessment of spot sign formation during acute ICH; this is the first study to quantitatively describe spot sign formation and morphology using dCTA.
Author Disclosures: S. Chakraborty: None. M. Alhazzaa: None. J. Wasserman: None. K. Sun: None. G. Stotts: None. M. Hogan: None. A. Demchuk: None. R. Aviv: None. D. Dowlatshahi: Research Grant; Modest; This study was funded by a Heart and Stroke Foundation of Ontario grant, and by the Department of Medicine, University of Ottawa. DD is supported by a Clinician-Scientist Award from the Heart and Str.
- © 2014 by American Heart Association, Inc.