Island Sign

Li, Qi; Liu, Qingjun; Yang, Wen‐Song; Wang, Xing-Chen; Zhao, Libo; Xiong, Xin; Li, Rui; Cao, Du; Zhu, Dan; Xiao, Wei; Xie, Peng

doi:10.1161/strokeaha.117.017985

Cited by 204 publications

(41 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The relatively hypodense area has an identifiable border and a difference of at least 28 HU between the two density regions [12,21]. The IS consists of at least 3 scattered small hematomas all separate from the main hematoma or at least 4 small hematomas some or all of which may connect with the main hematoma [14]. The imaging sign HD was defined as any hypodense region strictly encapsulated within the hemorrhage with any shape, size, and density which does not require a density measurement [6,15,22].…”

Section: Image Analysismentioning

confidence: 99%

“…To this end, several imaging markers on non-contrast computed tomography (NCCT) have been described to be predictive of hematoma expansion and poor functional outcome [6]. These imaging characteristics include the blend sign (BS) [6,11], the black hole sign (BHS) [6,12,13], the island sign (IS) [6,14], and the more general appearance of hypodensities (HD) [6,15]. In addition, a contrast extravasation on computed tomography angiogram (CTA) within an ICH is referred as the established spot sign [16,17].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Inter- and Intrarater Agreement of Spot Sign and Noncontrast CT Markers for Early Intracerebral Hemorrhage Expansion

Nawabi

Elsayed

Kniep

et al. 2020

JCM

View full text Add to dashboard Cite

Background: The aim of this study was to assess the inter- and intrarater reliability of noncontrast CT (NCCT) markers [Black Hole Sign (BH), Blend Sign (BS), Island Sign (IS), and Hypodensities (HD)] and Spot Sign (SS) on CTA in patients with spontaneous intracerebral hemorrhage (ICH). Methods: Patients with spontaneous ICH at three German tertiary stroke centers were retrospectively included. Each CT scan was rated for four NCCT markers and SS on CTA by two radiology residents. Raters were blind to all demographic and outcome data. Inter- and intrarater agreement was determined by Cohen’s kappa (κ) coefficient and percentage of agreement. Results: Interrater agreement was excellent in 473 included patients, ranging from 96% to 99%. Interrater κ ranged from 0.85 (95% CI [0.78–0.91]) to 0.97 (95% CI [0.94–0.99]) for NCCT markers and 0.93 (95% CI [0.88–0.98]) for SS, all p-values < 0.001. Intrarrater agreement ranged from 96% to 100%, with κ ranging from 0.85 (95% CI [0.78–0.91]) to 1.00 (95% CI [0.10–0.85]) for NCCT markers and 0.96 (95% CI [0.92–1.00]) for SS, all p-values < 0.001. Conclusions: NCCT imaging findings and SS on CTA have good-to-excellent inter- and intrarater reliabilities, with the highest agreement for BH and SS.

show abstract

Section: Image Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inter- and Intrarater Agreement of Spot Sign and Noncontrast CT Markers for Early Intracerebral Hemorrhage Expansion

Nawabi

Elsayed

Kniep

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Third, this was a retrospective clinical study and the sample size was relatively small. In addition, the black hole sign [ 40 ] and the island sign [ 41 ], which also indicate active bleeding, were are not studied and further studies are urgently needed to investigate the associations between hyperglycemia and these signs.…”

Section: Discussionmentioning

confidence: 99%

Hyperglycemia Predicts Blend Sign in Patients with Intracerebral Hemorrhage

Zhang

Qian

et al. 2018

Med Sci Monit

View full text Add to dashboard Cite

BackgroundPredictive values of admission blood glucose for early hematoma expansion in patients with intracranial hemorrhage (ICH) remain controversial. Blend sign is a novel image predictor for early hematoma growth that suggests presence of active bleeding. We investigated the association between hyperglycemia and blend sign in predicting early hematoma growth in ICH patients.Material/MethodsAll patients with intracranial hemorrhage were retrospectively reviewed. Clinical characteristics and radiological parameters were collected. Blood glucose was measured within 24 h after onset. CT scan results for hematoma expansion and blend sign were evaluated by 2 readers. Multivariate logistic regression analyses were applied to reveal the associations between hematoma growth and blend sign, as well as other variables.ResultsOut of 164 patients with ICH, 52 exhibited early hematoma growth and 18 of these were diagnosed with blend sign. Average blood glucose was 7.53 mmol/L among all patients. By using multivariate analyses, the time of CT scan baseline, GCS score, hematoma size, blend sign, and blood glucose were associated with hematoma expansion, whereas only hyperglycemia was associated with blend sign.ConclusionsAdmission hyperglycemia is associated with hematoma expansion in the presence of blend sign. These findings suggest that elevated blood glucose is a possible factor predicting continuous bleeding. Strategies to control blood glucose and ameliorate hematoma growth are urgently needed and will be investigated in our future studies.

show abstract

“…Previous randomized controlled trials reported that <25% of patients with ICH underwent CTA during the acute phase ( 5 , 6 ). Other research studies have reported that a number of indicators are associated with HE and poor outcomes in patients with ICH, including non-contrast CT (NCCT) markers, such as computed tomography (CT) hypodensities ( 7 ), the black hole sign ( 8 ), the blend sign ( 9 ), and the island sign ( 10 ). However, there is an urgent need for further research to identify the prognostic value of biomarkers for HE.…”

Section: Introductionmentioning

confidence: 99%

Associations Between Levels of High-Sensitivity C-Reactive Protein and Outcome After Intracerebral Hemorrhage

Wang

Liu

et al. 2020

Front. Neurol.

View full text Add to dashboard Cite

Background: Patients with spontaneous intracerebral hemorrhage (ICH) have high mortality and morbidity rates; approximately one-third of patients with ICH experience hematoma expansion (HE). The spot sign is an established and validated imaging marker for HE. High-sensitivity C-reactive protein (hs-CRP) is an established laboratory marker for inflammation and secondary brain injury following ICH. Objective: To determine the association between the spot sign and hs-CRP, hematoma expansion, and clinical outcomes. Methods: Between December 2014 and September 2016, we prospectively recruited 1,964 patients with acute symptomatic ICH at 13 hospitals in Beijing, China. Next, we selected 92 patients within 24 h of the onset of symptoms from this cohort for the present study. ICH was diagnosed in the emergency room by non-contrast computed tomography (NCCT) scans. Follow-up scans were carried out within 48 h to evaluate patients for HE. Multidetector computed tomography angiography (MDCTA) was also used to identify spot signs. Blood samples were collected from each patient at admission in EDTA tubes (for plasma) or vacutainer tubes (for serum). hs-CRP values were determined by a particle-enhanced immunoturbidimetric assay in the laboratory at Beijing Tiantan Hospital, Capital Medical University. Patients were categorized into two groups according to their hs-CRP levels (hs-CRP <3 mg/L, hs-CRP ≥3 mg/L). Results: The incidences of spot sign and HE in our study cohort were 31.5 and 29.3%, respectively. Following the removal of potential confounding variables, stepwise-forward logistic regression analysis identified that an hs-CRP level ≥3 mg/L was not a significant indicator for either spot sign ( p = 0.68) or HE ( p = 0.07). However, an hs-CRP level ≥3 mg/L (odds ratio: 16.64, 95% confidence interval: 2.11–131.45, p = 0.008) was identified as an independent predictor of an unfavorable outcome 1 year after acute ICH. Conclusions: Our analyses identified that an hs-CRP level ≥3 mg/L was a significant indicator for an unfavorable outcome 1 year after acute ICH.

show abstract

Island Sign

Abstract: The island sign is a reliable CT imaging marker that independently predicts hematoma expansion and poor outcome in patients with ICH. The noncontrast CT island sign may serve as a potential marker for therapeutic intervention.

Cited by 204 publications

References 33 publications

Inter- and Intrarater Agreement of Spot Sign and Noncontrast CT Markers for Early Intracerebral Hemorrhage Expansion

Inter- and Intrarater Agreement of Spot Sign and Noncontrast CT Markers for Early Intracerebral Hemorrhage Expansion

Hyperglycemia Predicts Blend Sign in Patients with Intracerebral Hemorrhage

Associations Between Levels of High-Sensitivity C-Reactive Protein and Outcome After Intracerebral Hemorrhage

Contact Info

Product

Resources

About