Intracerebral hemorrhage markers on non-contrast computed tomography as predictors of the dynamic spot sign on CT perfusion and associations with hematoma expansion and outcome
Purpose To assess the association between non-contrast computed tomography (NCCT) hematoma markers and the dynamic spot sign on computed tomography perfusion (CTP), and their associations with hematoma expansion, clinical outcome, and in-hospital mortality. Methods Patients who presented with intrac...
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| Veröffentlicht in: | Neuroradiology 2022-11, Vol.64 (11), p.2135-2144 |
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| creator | Truong, Michael Quangminh Metcalfe, Andrew Viggo Ovenden, Christopher Dillon Kleinig, Timothy John Barras, Christen David |
| description | Purpose
To assess the association between non-contrast computed tomography (NCCT) hematoma markers and the dynamic spot sign on computed tomography perfusion (CTP), and their associations with hematoma expansion, clinical outcome, and in-hospital mortality.
Methods
Patients who presented with intracerebral hemorrhage (ICH) to a stroke center over an 18-month period and underwent baseline NCCT and CTP, and a follow-up NCCT within 24 h after the baseline scan were included. The initial and follow-up hematoma volumes were calculated. Two raters independently assessed the baseline NCCT for hematoma markers and concurrently assessed the CTP for the dynamic spot sign. Univariate and multivariate logistic regression analyses were performed to assess the association between the hematoma markers and the dynamic spot sign, adjusting for known ICH expansion predictors.
Results
Eighty-five patients were included in our study and 55 patients were suitable for expansion analysis. Heterogeneous density was the only NCCT hematoma marker to be associated with the dynamic spot sign after multivariate analysis (odds ratio, 58.61; 95% confidence interval, 9.13–376.05;
P
|
| doi_str_mv | 10.1007/s00234-022-03032-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2712845811</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2712845811</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-50ecf8a272e2761c9b92a39b162974471c4dc17b2b6462ad656571397df5ef393</originalsourceid><addsrcrecordid>eNp9kcuO1DAQRS0EYpqBH2CBLLFhE_AjtpMlavEYaSQ2w9pynEonQ8cOLkdM_xWfiEMPg8SClV2qc2-V6hLykrO3nDHzDhkTsq6YEBWTTIpKPyI7XpcPbwV7THal31SyrdkFeYZ4yxiTRpqn5EJqZjRrmh35eRVych4SdMkd6QhzTGl0B6CzS98gIY2BhhgqHzcQM_VxXtYMPc1xjofklvFEHdIlQT_5HDfFQPMItD8FN0-e4hIzxekQNqv9DV0gDStOpXChL1KMfnK51Eh_THncdnDF21G4W1x4AOOay2h4Tp4M7ojw4v69JF8_frjZf66uv3y62r-_rrw0KleKgR8aJ4wAYTT3bdcKJ9uOa9Gaujbc173nphOdrrVwvVZaGS5b0w8KBtnKS_Lm7Luk-H0FzHae0MPx6ALEFa0wXDS1ajgv6Ot_0Nu4plC2K5RQtRKyUYUSZ8qniJhgsEuaypFPljO75WnPedqSp_2dp9VF9Oreeu1m6B8kfwIsgDwDWFrhAOnv7P_Y_gIrna5s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2725452385</pqid></control><display><type>article</type><title>Intracerebral hemorrhage markers on non-contrast computed tomography as predictors of the dynamic spot sign on CT perfusion and associations with hematoma expansion and outcome</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Truong, Michael Quangminh ; Metcalfe, Andrew Viggo ; Ovenden, Christopher Dillon ; Kleinig, Timothy John ; Barras, Christen David</creator><creatorcontrib>Truong, Michael Quangminh ; Metcalfe, Andrew Viggo ; Ovenden, Christopher Dillon ; Kleinig, Timothy John ; Barras, Christen David</creatorcontrib><description>Purpose
To assess the association between non-contrast computed tomography (NCCT) hematoma markers and the dynamic spot sign on computed tomography perfusion (CTP), and their associations with hematoma expansion, clinical outcome, and in-hospital mortality.
Methods
Patients who presented with intracerebral hemorrhage (ICH) to a stroke center over an 18-month period and underwent baseline NCCT and CTP, and a follow-up NCCT within 24 h after the baseline scan were included. The initial and follow-up hematoma volumes were calculated. Two raters independently assessed the baseline NCCT for hematoma markers and concurrently assessed the CTP for the dynamic spot sign. Univariate and multivariate logistic regression analyses were performed to assess the association between the hematoma markers and the dynamic spot sign, adjusting for known ICH expansion predictors.
Results
Eighty-five patients were included in our study and 55 patients were suitable for expansion analysis. Heterogeneous density was the only NCCT hematoma marker to be associated with the dynamic spot sign after multivariate analysis (odds ratio, 58.61; 95% confidence interval, 9.13–376.05;
P
< 0.001). The dynamic spot sign was present in 22 patients (26%) and significantly predicted hematoma expansion (odds ratio, 36.6; 95% confidence interval, 2.51–534.2;
P
= 0.008). All patients with a spot sign had a swirl sign. A co-located hypodensity and spot sign was significantly associated with in-hospital mortality (odds ratio, 6.17; 95% confidence interval, 1.09–34.78;
P
= 0.039).
Conclusion
Heterogeneous density and swirl sign are associated with the dynamic spot sign. The dynamic spot sign is a stronger predictor than NCCT hematoma markers of significant hematoma expansion. A co-located spot sign and hypodensity predicts in-hospital mortality.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-022-03032-6</identifier><identifier>PMID: 36076088</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Biomarkers ; Cerebral Angiography - methods ; Cerebral Hemorrhage - diagnostic imaging ; Computed tomography ; Computed Tomography Angiography ; Confidence intervals ; Density ; Diagnostic Neuroradiology ; Hematoma ; Hematoma - diagnostic imaging ; Hemorrhage ; Humans ; Imaging ; Markers ; Medicine ; Medicine & Public Health ; Mortality ; Multivariate analysis ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Patients ; Perfusion ; Radiology ; Regression analysis ; Statistical analysis ; Tomography ; Tomography, X-Ray Computed - methods</subject><ispartof>Neuroradiology, 2022-11, Vol.64 (11), p.2135-2144</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. corrected publication 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-50ecf8a272e2761c9b92a39b162974471c4dc17b2b6462ad656571397df5ef393</citedby><cites>FETCH-LOGICAL-c375t-50ecf8a272e2761c9b92a39b162974471c4dc17b2b6462ad656571397df5ef393</cites><orcidid>0000-0003-3448-2792 ; 0000-0003-4430-3276 ; 0000-0003-1899-1909 ; 0000-0002-7680-3577</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00234-022-03032-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-022-03032-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36076088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Truong, Michael Quangminh</creatorcontrib><creatorcontrib>Metcalfe, Andrew Viggo</creatorcontrib><creatorcontrib>Ovenden, Christopher Dillon</creatorcontrib><creatorcontrib>Kleinig, Timothy John</creatorcontrib><creatorcontrib>Barras, Christen David</creatorcontrib><title>Intracerebral hemorrhage markers on non-contrast computed tomography as predictors of the dynamic spot sign on CT perfusion and associations with hematoma expansion and outcome</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Purpose
To assess the association between non-contrast computed tomography (NCCT) hematoma markers and the dynamic spot sign on computed tomography perfusion (CTP), and their associations with hematoma expansion, clinical outcome, and in-hospital mortality.
Methods
Patients who presented with intracerebral hemorrhage (ICH) to a stroke center over an 18-month period and underwent baseline NCCT and CTP, and a follow-up NCCT within 24 h after the baseline scan were included. The initial and follow-up hematoma volumes were calculated. Two raters independently assessed the baseline NCCT for hematoma markers and concurrently assessed the CTP for the dynamic spot sign. Univariate and multivariate logistic regression analyses were performed to assess the association between the hematoma markers and the dynamic spot sign, adjusting for known ICH expansion predictors.
Results
Eighty-five patients were included in our study and 55 patients were suitable for expansion analysis. Heterogeneous density was the only NCCT hematoma marker to be associated with the dynamic spot sign after multivariate analysis (odds ratio, 58.61; 95% confidence interval, 9.13–376.05;
P
< 0.001). The dynamic spot sign was present in 22 patients (26%) and significantly predicted hematoma expansion (odds ratio, 36.6; 95% confidence interval, 2.51–534.2;
P
= 0.008). All patients with a spot sign had a swirl sign. A co-located hypodensity and spot sign was significantly associated with in-hospital mortality (odds ratio, 6.17; 95% confidence interval, 1.09–34.78;
P
= 0.039).
Conclusion
Heterogeneous density and swirl sign are associated with the dynamic spot sign. The dynamic spot sign is a stronger predictor than NCCT hematoma markers of significant hematoma expansion. A co-located spot sign and hypodensity predicts in-hospital mortality.</description><subject>Biomarkers</subject><subject>Cerebral Angiography - methods</subject><subject>Cerebral Hemorrhage - diagnostic imaging</subject><subject>Computed tomography</subject><subject>Computed Tomography Angiography</subject><subject>Confidence intervals</subject><subject>Density</subject><subject>Diagnostic Neuroradiology</subject><subject>Hematoma</subject><subject>Hematoma - diagnostic imaging</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Imaging</subject><subject>Markers</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Patients</subject><subject>Perfusion</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Statistical analysis</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kcuO1DAQRS0EYpqBH2CBLLFhE_AjtpMlavEYaSQ2w9pynEonQ8cOLkdM_xWfiEMPg8SClV2qc2-V6hLykrO3nDHzDhkTsq6YEBWTTIpKPyI7XpcPbwV7THal31SyrdkFeYZ4yxiTRpqn5EJqZjRrmh35eRVych4SdMkd6QhzTGl0B6CzS98gIY2BhhgqHzcQM_VxXtYMPc1xjofklvFEHdIlQT_5HDfFQPMItD8FN0-e4hIzxekQNqv9DV0gDStOpXChL1KMfnK51Eh_THncdnDF21G4W1x4AOOay2h4Tp4M7ojw4v69JF8_frjZf66uv3y62r-_rrw0KleKgR8aJ4wAYTT3bdcKJ9uOa9Gaujbc173nphOdrrVwvVZaGS5b0w8KBtnKS_Lm7Luk-H0FzHae0MPx6ALEFa0wXDS1ajgv6Ot_0Nu4plC2K5RQtRKyUYUSZ8qniJhgsEuaypFPljO75WnPedqSp_2dp9VF9Oreeu1m6B8kfwIsgDwDWFrhAOnv7P_Y_gIrna5s</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Truong, Michael Quangminh</creator><creator>Metcalfe, Andrew Viggo</creator><creator>Ovenden, Christopher Dillon</creator><creator>Kleinig, Timothy John</creator><creator>Barras, Christen David</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3448-2792</orcidid><orcidid>https://orcid.org/0000-0003-4430-3276</orcidid><orcidid>https://orcid.org/0000-0003-1899-1909</orcidid><orcidid>https://orcid.org/0000-0002-7680-3577</orcidid></search><sort><creationdate>20221101</creationdate><title>Intracerebral hemorrhage markers on non-contrast computed tomography as predictors of the dynamic spot sign on CT perfusion and associations with hematoma expansion and outcome</title><author>Truong, Michael Quangminh ; Metcalfe, Andrew Viggo ; Ovenden, Christopher Dillon ; Kleinig, Timothy John ; Barras, Christen David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-50ecf8a272e2761c9b92a39b162974471c4dc17b2b6462ad656571397df5ef393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biomarkers</topic><topic>Cerebral Angiography - methods</topic><topic>Cerebral Hemorrhage - diagnostic imaging</topic><topic>Computed tomography</topic><topic>Computed Tomography Angiography</topic><topic>Confidence intervals</topic><topic>Density</topic><topic>Diagnostic Neuroradiology</topic><topic>Hematoma</topic><topic>Hematoma - diagnostic imaging</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Imaging</topic><topic>Markers</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Patients</topic><topic>Perfusion</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Statistical analysis</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Truong, Michael Quangminh</creatorcontrib><creatorcontrib>Metcalfe, Andrew Viggo</creatorcontrib><creatorcontrib>Ovenden, Christopher Dillon</creatorcontrib><creatorcontrib>Kleinig, Timothy John</creatorcontrib><creatorcontrib>Barras, Christen David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Truong, Michael Quangminh</au><au>Metcalfe, Andrew Viggo</au><au>Ovenden, Christopher Dillon</au><au>Kleinig, Timothy John</au><au>Barras, Christen David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intracerebral hemorrhage markers on non-contrast computed tomography as predictors of the dynamic spot sign on CT perfusion and associations with hematoma expansion and outcome</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2022-11-01</date><risdate>2022</risdate><volume>64</volume><issue>11</issue><spage>2135</spage><epage>2144</epage><pages>2135-2144</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Purpose
To assess the association between non-contrast computed tomography (NCCT) hematoma markers and the dynamic spot sign on computed tomography perfusion (CTP), and their associations with hematoma expansion, clinical outcome, and in-hospital mortality.
Methods
Patients who presented with intracerebral hemorrhage (ICH) to a stroke center over an 18-month period and underwent baseline NCCT and CTP, and a follow-up NCCT within 24 h after the baseline scan were included. The initial and follow-up hematoma volumes were calculated. Two raters independently assessed the baseline NCCT for hematoma markers and concurrently assessed the CTP for the dynamic spot sign. Univariate and multivariate logistic regression analyses were performed to assess the association between the hematoma markers and the dynamic spot sign, adjusting for known ICH expansion predictors.
Results
Eighty-five patients were included in our study and 55 patients were suitable for expansion analysis. Heterogeneous density was the only NCCT hematoma marker to be associated with the dynamic spot sign after multivariate analysis (odds ratio, 58.61; 95% confidence interval, 9.13–376.05;
P
< 0.001). The dynamic spot sign was present in 22 patients (26%) and significantly predicted hematoma expansion (odds ratio, 36.6; 95% confidence interval, 2.51–534.2;
P
= 0.008). All patients with a spot sign had a swirl sign. A co-located hypodensity and spot sign was significantly associated with in-hospital mortality (odds ratio, 6.17; 95% confidence interval, 1.09–34.78;
P
= 0.039).
Conclusion
Heterogeneous density and swirl sign are associated with the dynamic spot sign. The dynamic spot sign is a stronger predictor than NCCT hematoma markers of significant hematoma expansion. A co-located spot sign and hypodensity predicts in-hospital mortality.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36076088</pmid><doi>10.1007/s00234-022-03032-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3448-2792</orcidid><orcidid>https://orcid.org/0000-0003-4430-3276</orcidid><orcidid>https://orcid.org/0000-0003-1899-1909</orcidid><orcidid>https://orcid.org/0000-0002-7680-3577</orcidid></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Biomarkers Cerebral Angiography - methods Cerebral Hemorrhage - diagnostic imaging Computed tomography Computed Tomography Angiography Confidence intervals Density Diagnostic Neuroradiology Hematoma Hematoma - diagnostic imaging Hemorrhage Humans Imaging Markers Medicine Medicine & Public Health Mortality Multivariate analysis Neurology Neuroradiology Neurosciences Neurosurgery Patients Perfusion Radiology Regression analysis Statistical analysis Tomography Tomography, X-Ray Computed - methods |
| title | Intracerebral hemorrhage markers on non-contrast computed tomography as predictors of the dynamic spot sign on CT perfusion and associations with hematoma expansion and outcome |
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