Edinburgh Imaging

MSc projects 1314 002

Intracerebral haemorrhage expansion – assessment of imaging quality & predictors of expansion.

  • Introduction: Spontaneous intracererbral haemorrhage (ICH) is a devastating disease for which no effective treatments are currently available. ICH expansion occurs in a subset of patients and is associated with worse neurological outcome. The aim of my study was to identify predictors of haematoma growth, and to assess whether the results of studies using repeat scans on individual patients for volumetric assessment of ICH can be relied upon based on their imaging quality.

  • Methods: I systematically searched Ovid Medline (from 1950) for studies where patients with primary ICH had a baseline and at least one follow-up scan. Authors were invited to collaborate by sharing the data, including data on imaging quality. After summarizing the data, I used multivariate linear regression to identify predictors of ICH expansion.

  • Results: My search identified 1281 potentially eligible studies. Data were requested for 37 of these that fully met my eligibility criteria. The final cohort consisted of 14 studies reporting results for 2,581 individual patients. Computed tomography (CT) was the most commonly used imaging modality, and most studies used the ABC/2 method to estimate haematoma volume. However, information on imaging characteristics, acquisition protocols, and image quality was very limited. Systolic blood pressure and blood platelet levels at presentation, as well as the presence of the CT angiography (CTA) spot sign were the most significant predictors of ICH expansion (p<0.05).

  • Conclusions: Systolic blood pressure and platelet levels at presentation are potentially modifiable factors that predict ICH expansion. These, along with the presence of the CTA spot sign, may be used to identify suitable patients for clinical trials of haemostatic treatments. However, imaging quality of volumetric studies should improve before we can rely on these results to inform clinical decisions.

Project type:
  • Meta-analysis
  • Systematic review
Imaging keywords:
Application / disease keywords:
  • Intracererbral haemorrhage (ICH)
  • 13-14