MRI Spot Sign In Acute Intracerebral Hemorrhage: An Independent Biomarker of Hematoma Expansion and Poor Functional Outcome - Archive ouverte HAL Access content directly
Journal Articles Journal of Neurology Year : 2022

MRI Spot Sign In Acute Intracerebral Hemorrhage: An Independent Biomarker of Hematoma Expansion and Poor Functional Outcome

(1) , (1) , (2) , (1) , (1) , (1) , (1) , (1) , (1) , (3, 1)
1
2
3

Abstract

Background: In acute intracerebral hemorrhage (ICH), the prognostic value of the MRI spot sign on hematoma expansion (HE) and poor functional outcome is poorly known. Methods: We retrospectively included patients admitted over a 4-year period for an acute ICH in a single institution using MRI as the first-line imaging tool. The presence and number of MRI spot signs on contrast-enhanced T1-weighted imaging was evaluated by one neuroradiologist, blinded from outcomes. The primary outcome was HE, defined as > 6 mL or > 33% ICH volume growth from initial MRI to 24-48 h follow-up imaging; the secondary outcome was poor 3-month modified Rankin score (4-6). Results: Overall, 147 patients were included, and 62% had a spot sign. Among the 130 patients with follow-up imaging, 24% experienced HE. HE occurred in 6%, 21% and 43% patients with 0, 1 and ≥ 2 spots, respectively (P < 0.001). The MRI spot sign was independently associated with HE (adjusted OR 6.15 [95% CI 1.60-23.65]; P = 0.008), with a dose-dependent effect. The negative and positive predictive values of the spot sign for HE were 0.94 and 0.35, respectively. Poor functional outcome occurred in 27%, 32% and 71% patients with 0, 1 and ≥ 2 spots, respectively (P < 0.001). In multivariable analysis, the presence of ≥ 2 spots was independently associated with poor functional outcome (adjusted OR 3.67 [95% CI 1.21-11.10]; P = 0.024). Conclusion: The MRI spot sign is an independent biomarker of HE, and the presence of ≥ 2 spots is independently associated with poor 3-month outcome. The lack of spot sign is highly predictive of a favorable evolution.
Embargoed file
Embargoed file
0 3 22
Year Month Jours
Avant la publication

Dates and versions

inserm-03878769 , version 1 (30-11-2022)

Identifiers

Cite

Nefeli Valyraki, Adrien Goujon, Marjorie Mateos, Adrien Lecoeuvre, Augustin Lecler, et al.. MRI Spot Sign In Acute Intracerebral Hemorrhage: An Independent Biomarker of Hematoma Expansion and Poor Functional Outcome. Journal of Neurology, 2022, Online ahead of print. ⟨10.1007/s00415-022-11498-w⟩. ⟨inserm-03878769⟩

Collections

INSERM UP-SANTE
0 View
0 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More