The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis.
<h4>Purpose</h4>The role of spot sign on computed tomography angiography (CTA) for predicting hematoma expansion (HE) after primary intracerebral hemorrhage (ICH) has been the focus of many studies. Our study sought to evaluate the predictive accuracy of spot signs for HE in a meta-analy...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2014-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0115777 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849254184771125248 |
|---|---|
| author | Fei-Zhou Du Rui Jiang Ming Gu Ci He Jing Guan |
| author_facet | Fei-Zhou Du Rui Jiang Ming Gu Ci He Jing Guan |
| author_sort | Fei-Zhou Du |
| collection | DOAJ |
| description | <h4>Purpose</h4>The role of spot sign on computed tomography angiography (CTA) for predicting hematoma expansion (HE) after primary intracerebral hemorrhage (ICH) has been the focus of many studies. Our study sought to evaluate the predictive accuracy of spot signs for HE in a meta-analytic approach.<h4>Materials and methods</h4>The database of Pubmed, Embase, and the Cochrane Library were searched for eligible studies. Researches were included if they reported data on HE in primary ICH patients, assessed by spot sign on first-pass CTA. Studies with additional data of second-pass CTA, post-contrast CT (PCCT) and CT perfusion (CTP) were also included.<h4>Results</h4>18 studies were pooled into the meta-analysis, including 14 studies of first-pass CTA, and 7 studies of combined CT modalities. In evaluating the accuracy of spot sign for predicting HE, studies of first-pass CTA showed that the sensitivity was 53% (95% CI, 49%-57%) with a specificity of 88% (95% CI, 86%-89%). The pooled positive likelihood ratio (PLR) was 4.70 (95% CI, 3.28-6.74) and the negative likelihood ratio (NLR) was 0.44 (95% CI, 0.34-0.58). For studies of combined CT modalities, the sensitivity was 73% (95% CI, 67%-79%) with a specificity of 88% (95% CI, 86%-90%). The aggregated PLR was 6.76 (95% CI, 3.70-12.34) and the overall NLR was 0.17 (95% CI 0.06-0.48).<h4>Conclusions</h4>Spot signs appeared to be a reliable imaging biomarker for HE. The additional detection of delayed spot sign was helpful in improving the predictive accuracy of early spot signs. Awareness of our results may impact the primary ICH care by providing supportive evidence for the use of combined CT modalities in detecting spot signs. |
| format | Article |
| id | doaj-art-e23a2120512b468ab37174ebaa179a64 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-e23a2120512b468ab37174ebaa179a642025-08-20T03:56:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11577710.1371/journal.pone.0115777The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis.Fei-Zhou DuRui JiangMing GuCi HeJing Guan<h4>Purpose</h4>The role of spot sign on computed tomography angiography (CTA) for predicting hematoma expansion (HE) after primary intracerebral hemorrhage (ICH) has been the focus of many studies. Our study sought to evaluate the predictive accuracy of spot signs for HE in a meta-analytic approach.<h4>Materials and methods</h4>The database of Pubmed, Embase, and the Cochrane Library were searched for eligible studies. Researches were included if they reported data on HE in primary ICH patients, assessed by spot sign on first-pass CTA. Studies with additional data of second-pass CTA, post-contrast CT (PCCT) and CT perfusion (CTP) were also included.<h4>Results</h4>18 studies were pooled into the meta-analysis, including 14 studies of first-pass CTA, and 7 studies of combined CT modalities. In evaluating the accuracy of spot sign for predicting HE, studies of first-pass CTA showed that the sensitivity was 53% (95% CI, 49%-57%) with a specificity of 88% (95% CI, 86%-89%). The pooled positive likelihood ratio (PLR) was 4.70 (95% CI, 3.28-6.74) and the negative likelihood ratio (NLR) was 0.44 (95% CI, 0.34-0.58). For studies of combined CT modalities, the sensitivity was 73% (95% CI, 67%-79%) with a specificity of 88% (95% CI, 86%-90%). The aggregated PLR was 6.76 (95% CI, 3.70-12.34) and the overall NLR was 0.17 (95% CI 0.06-0.48).<h4>Conclusions</h4>Spot signs appeared to be a reliable imaging biomarker for HE. The additional detection of delayed spot sign was helpful in improving the predictive accuracy of early spot signs. Awareness of our results may impact the primary ICH care by providing supportive evidence for the use of combined CT modalities in detecting spot signs.https://doi.org/10.1371/journal.pone.0115777 |
| spellingShingle | Fei-Zhou Du Rui Jiang Ming Gu Ci He Jing Guan The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis. PLoS ONE |
| title | The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis. |
| title_full | The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis. |
| title_fullStr | The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis. |
| title_full_unstemmed | The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis. |
| title_short | The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis. |
| title_sort | accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage a systematic review and meta analysis |
| url | https://doi.org/10.1371/journal.pone.0115777 |
| work_keys_str_mv | AT feizhoudu theaccuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT ruijiang theaccuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT minggu theaccuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT cihe theaccuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT jingguan theaccuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT feizhoudu accuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT ruijiang accuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT minggu accuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT cihe accuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis AT jingguan accuracyofspotsigninpredictinghematomaexpansionafterintracerebralhemorrhageasystematicreviewandmetaanalysis |