Value of the spot sign combined with the blend sign for predicting the outcome of patients with intracerebral hemorrhage who have undergone stereotactic minimally invasive surgery.

Objective: This study aimed to explore the effect of combining the computed tomographic angiography (CTA) spot sign with the computed tomography (CT) blend sign for predicting the outcome of patients with intracerebral hemorrhage (ICH) who have undergone stereotactic minimally invasive surgery (sMIS).

Methods: Patients with ICH treated with sMIS between January 2018 and April 2023 at the affiliated hospital of Guizhou Medical University were retrospectively included. A modified Rankin scale (mRS) score of ≥3 at 3 months was defined as a poor outcome. According to neurological recovery, patients were assigned to either the poor outcome (90 patients) or the good outcome (105 patients) groups. The value of the combined signs in predicting the outcome of patients with ICH who have undergone sMIS was analyzed via the receiver operating characteristic (ROC) curve.

Results: Among a total of 195 patients, 29 (14.8%) had single blend signs, 35 (17.9%) had single spot signs, 76 (39%) had combined signs, and 55 (28.2%) had CT-negative. A multivariate binary logistic regression analysis revealed that the spot sign combined with the blend sign (OR = 5.244, 95% CI: 2.606-10.55,  < 0.001) and hematoma expansion (HE) (OR = 2.063, 95% CI: 1.003-4.245,  = 0.049) were associated with poor outcomes ( < 0.001). The ROC curve analysis revealed that the sensitivity and specificity of the spot sign and blend sign combination for outcome prediction were 61.1 and 80.0%, respectively; the Youden index was 0.411, and the area under the curve (AUC) value was 0.706.

Conclusion: The spot sign combined with the blend sign and hematoma topography may have predictive value for outcomes in patients with ICH undergoing sMIS.