Standards for Detecting, Interpreting, and Reporting Noncontrast Computed Tomographic Markers of Intracerebral Hemorrhage Expansion

Andrea Morotti; Gregoire Boulouis; Dar Dowlatshahi; Qi Li; Christen D Barras; Candice Delcourt; Zhiyuan Yu; Jun Zheng; Zien Zhou; Richard I Aviv; Ashkan Shoamanesh; Peter B Sporns; Jonathan Rosand; Steven M Greenberg; Rustam Al-Shahi Salman; Adnan I Qureshi; Andrew M Demchuk; Craig S Anderson; Joshua N Goldstein; Andreas Charidimou; International NCCT ICH Study Group

doi:10.1002/ana.25563

Standards for Detecting, Interpreting, and Reporting Noncontrast Computed Tomographic Markers of Intracerebral Hemorrhage Expansion

Ann Neurol. 2019 Oct;86(4):480-492. doi: 10.1002/ana.25563. Epub 2019 Aug 24.

Authors

Andrea Morotti¹, Gregoire Boulouis², Dar Dowlatshahi³, Qi Li⁴, Christen D Barras⁵, Candice Delcourt^{6

7}, Zhiyuan Yu⁸, Jun Zheng⁸, Zien Zhou^{7

9}, Richard I Aviv¹⁰, Ashkan Shoamanesh¹¹, Peter B Sporns¹², Jonathan Rosand^{13

14

15}, Steven M Greenberg¹³, Rustam Al-Shahi Salman¹⁶, Adnan I Qureshi¹⁷, Andrew M Demchuk¹⁸, Craig S Anderson^{6

7}, Joshua N Goldstein^{13

14

19}, Andreas Charidimou¹³; International NCCT ICH Study Group

Affiliations

¹ Department of Neurology and Neurorehabilitation, IRCCS Mondino Foundation, Pavia, Italy.
² Université de Paris, INSERM UMR 1266 IMA-BRAIN, Department of Neuroradiology, Centre Hospitalier Sainte Anne, Paris, France.
³ Department of Medicine (Neurology), University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
⁴ Department of Neurology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁵ South Australian Health and Medical Research Institute and Department of Radiology, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia.
⁶ Department of Neurology, Royal Prince Alfred Hospital, Sydney Health Partners, University of Sydney, Sydney, New South Wales, Australia.
⁷ George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁸ Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
⁹ Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
¹⁰ Division of Neuroradiology and Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
¹¹ Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada.
¹² Institute of Clinical Radiology, University of Münster, Münster, Germany.
¹³ J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
¹⁴ Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
¹⁵ Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA.
¹⁶ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
¹⁷ Zeenat Qureshi Stroke Institute, St Cloud, MN.
¹⁸ Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
¹⁹ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

PMID: 31364773
DOI: 10.1002/ana.25563

Abstract

Significant hematoma expansion (HE) affects one-fifth of people within 24 hours after acute intracerebral hemorrhage (ICH), and its prevention is an appealing treatment target. Although the computed tomography (CT)-angiography spot sign predicts HE, only a minority of ICH patients receive contrast injection. Conversely, noncontrast CT (NCCT) is used to diagnose nearly all ICH, so NCCT markers represent a widely available alternative for prediction of HE. However, different NCCT signs describe similar features, with lack of consensus on the optimal image acquisition protocol, assessment, terminology, and diagnostic criteria. In this review, we propose practical guidelines for detecting, interpreting, and reporting NCCT predictors of HE. ANN NEUROL 2019;86:480-492.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Cerebral Hemorrhage / complications
Cerebral Hemorrhage / diagnostic imaging*
Guidelines as Topic*
Hematoma / complications
Hematoma / diagnostic imaging*
Humans
Tomography, X-Ray Computed / standards*

Abstract

Publication types

MeSH terms

Grants and funding