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Research ArticleBrain

CT Perfusion Spot Sign Improves Sensitivity for Prediction of Outcome Compared with CTA and Postcontrast CT

A. Koculym, T.J. Huynh, R. Jakubovic, L. Zhang and R.I. Aviv
American Journal of Neuroradiology May 2013, 34 (5) 965-970; DOI: https://doi.org/10.3174/ajnr.A3338
A. Koculym
aFrom the Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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T.J. Huynh
aFrom the Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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R. Jakubovic
aFrom the Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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L. Zhang
aFrom the Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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R.I. Aviv
aFrom the Department of Medical Imaging, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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    Fig 1.

    A, NCCT demonstrates an ICH, with IVH extension, without evidence of calcification within. B, No spot signs are detected on CTA. C, CTP identifies a 2-mm spot sign (arrow) with maximum attenuation appearing 40 seconds after contrast bolus. D, PCT demonstrates no definite contrast extravasation. The patient clinically deteriorated rapidly and died before 24-hour CT.

Tables

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  • Spot sign characteristics

    CTA Spot Positive (n = 8)CTP Spot Positive (n = 14)PCT Spot Positive (n = 9)P Valuea
    Spot No.2 (1–4)3 (1–6)2 (1–2).178
    Maximum attenuation (HU)252 (195–285)219 (155–308)140 (130–46).011
    Maximum axial dimension (mm)4.6 (2.5–6.6)9.1 (4.7–20.1)19.0 (11.0–21.3).055
    Spot sign score3 (2–3)3.5 (1–4)2 (2–3).125
    Time from contrast injection to maximum attenuation (sec)24 (22–26)50 (34–63)339 (308–370)<.001
    • ↵a Overall difference among groups determined by Kruskal-Wallis test.

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American Journal of Neuroradiology: 34 (5)
American Journal of Neuroradiology
Vol. 34, Issue 5
1 May 2013
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A. Koculym, T.J. Huynh, R. Jakubovic, L. Zhang, R.I. Aviv
CT Perfusion Spot Sign Improves Sensitivity for Prediction of Outcome Compared with CTA and Postcontrast CT
American Journal of Neuroradiology May 2013, 34 (5) 965-970; DOI: 10.3174/ajnr.A3338

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CT Perfusion Spot Sign Improves Sensitivity for Prediction of Outcome Compared with CTA and Postcontrast CT
A. Koculym, T.J. Huynh, R. Jakubovic, L. Zhang, R.I. Aviv
American Journal of Neuroradiology May 2013, 34 (5) 965-970; DOI: 10.3174/ajnr.A3338
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