Non-contrast computed tomography features predict intraventricular hemorrhage growth

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Non-contrast computed tomography (NCCT) markers are established predictors of parenchymal hematoma expansion in intracerebral hemorrhage (ICH).
• The utility of NCCT features in predicting intraventricular hemorrhage (IVH) growth remains less explored.

Purpose of the Study:

• To investigate whether specific NCCT features can identify patients with ICH who are at risk of IVH growth.
• To explore subtype-specific differences in the association between NCCT markers and IVH growth.

Main Methods:

• Retrospective analysis of 731 patients with acute spontaneous ICH from four tertiary centers.
• NCCT markers including heterogeneous density, hypodensity, black hole sign, swirl sign, blend sign, fluid level, island sign, satellite sign, and irregular shape were assessed.
• IVH growth was defined as expansion >1 mL (eIVH) or any delayed IVH (dIVH); multivariable logistic regression was used to identify predictors.

Main Results:

• 185 patients (25.31%) experienced IVH growth, with 130 (17.78%) showing eIVH and 55 (7.52%) showing dIVH.
• Irregular shape was significantly associated with overall IVH growth (OR 1.68).
• Hypodensities were linked to eIVH (OR 2.06), while irregular shape was associated with dIVH (OR 2.72). Parenchymal hematoma expansion did not mediate these associations.

Conclusions:

• Baseline NCCT features can identify ICH patients at high risk for IVH growth.
• Specific NCCT markers show subtype-specific associations with different types of IVH growth.
• These findings support the use of baseline NCCT for risk stratification of IVH growth and may inform future clinical studies.