Abstract: Objective To explore the spot sign on computed tomography angiography source image(CTA-SI) in order to assist in individualizing therapeutic decisions for patients by possibly forecasting hematoma enlargement.Methods Fifty-three patients with spontaneous intracerebral hemorrhage(ICH) were examined by non-contrast computed tomography(CT) and computed tomography angiography(CTA) within 6 hours after symptom onset. CTA-SI was reviewed by 3 neuroradiologists to make sure presence or absence of the spot sign. Hematoma volumes were determined from non-contrast CT images and compared between first and second CT images.Results Thirteen patients(24.5%) present of spot sign. Hematoma expansion occurred in 15 patients(28.3%) on follow-up. In which 12 patients present of spot sign. Sensitivity, specificity, positive predictive value, and negative predictive value for expansion were 80.0%, 97.4%, 92.3%, 92.5%, respectively. In patients with the spot sign, hematoma volume has significant difference in first and second CT images(P<0.05). In patients without the spot sign, hematoma volume has no significant difference in first and second CT images(P>0.05).Conclusions In acute ICH patients, CTA spot sign provided more radiological information that maybe assisted in individualizing therapeutic decisions for patients by possibly forecasting hematoma enlargement.

Key words: Intracranial hemorrhage; hypertensive; Cerebral angiography; Hematoma

摘要： 目的 探索电子计算机断层扫描血管造影（computed tomography angiography, CTA）原始图像中点征在预测血肿扩大中的应用价值。方法 对53例高血压脑出血患者在发病6小时内进行电子计算机断层扫描（computed tomography，CT）平扫及CTA检查，并在发病24 h后复查CT平扫。由3名放射科医师在CTA原始图像中寻找点征，同时对比两次检查的血肿体积。结果 13例患者（24.5%）CTA原始图像中点征为阳性。共有15例患者（28.3%）发生血肿扩大，其中12例为点征阳性患者。CTA原始图像预测血肿扩大的灵敏度、特异度、阳性预测值、阴性预测值分别为80.0%、97.4%、92.3%、92.5%。点征阳性患者初诊和复诊的血肿体积差异具有统计学意义（P<0.05），而点征阴性患者初诊和复诊的血肿体积差异不具有统计学意义（P>0.05）。结论 在急性高血压脑出血患者中，CTA点征可以给我们提供更多的影像学信息，有效预测血肿扩大。

关键词: 高血压脑出血; 脑血管造影术; 血肿