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KMID : 1005420070090040238
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Journal of Cerebrovascular and Endovascular Neurosurgery
2007 Volume.9 No. 4 p.238 ~ p.242
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The Usefulness of Contrast Extravasation on CT Angiography in Spontaneous Intracerebral Hemorrhage
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Hong Soon-Ki
Pyen Jhin-Soo
Jung Hyun-Ho
Keum Han-Joong
Whang Kum
Hu Chul
Kim Hun-Joo
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Abstract
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Objective: The authors investigated the clinical and radiographic characteristics of patients who exhibited contrast extravasation on initial computed tomographic angiography (CTA) and assessed the its association with hematoma expansion.
Methods: Ninety six patients who were diagnosed with intracerebral hemorrhage and who received CTA within 12 hours from initial onset of symptoms and who received a follow up brain CT within 48 hours from the initial CTA between April 2004 and March 2007 were retrospectively assessed. Contrast extravasation was defined as the presence of high-density material within the hematoma. Patients were classified into the extravasation and no extravasation groups. Clinical and radiographic variables were compared between the two groups.
Results: Fifteen patients (19%) demonstrated presence of extravasation on initial CTA. A significantly higher rate of hematoma expansion was seen in the extravasation group compared to the non extravasation group (47% vs 17%, p=0.027). Mean time from onset of symptoms to initial CTA was significantly shorter in the extravasation group (3.5+/-1.3 hours vs 7.6+/-2.5 hours, p<0.001). Also, detection of extravasation on CTA significantly correlated with time from symptom onset to intial CTA, especially when it was less than 4 hours (p>0.001).
Conclusions: Earlier detection of extravasation using CTA may help in identifying possibly life threatening complications caused by hematoma expansion. However, a larger prospective cohort is warranted to validate this result.
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KEYWORD
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Computed tomography angiography, Intracerebral hemorrhage, Extravasation
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