Abstract:Objective To investigate the correlation between spot sign (SS) on energy computed tomography angiography (CTA) and the risk of hematoma enlargement (HE) in patients with hypertensive intracerebral hemorrhage (HICH). Methods A total of 115 patients with HICH admitted to Luzhou People's Hospital from January 2019 to September 2022 were included. All patients received conventional treatment for intracerebral hemorrhage, and during hospitalization, they were divided into enlarged group and non-enlarged group according to whether HE occurred. Demographic data, clinical characteristics, and laboratory examination data were analyzed, and multivariate logistic regression analysis was used to identify the factors associated with HE. Results Among the 115 patients with HICH, 41 had HE as the enlarged group, while 74 did not have HE as the non-enlarged group. Univariate analysis showed that there was no significant difference in general information between the two groups (P＞0.05); CTA SS score was higher in the enlarged group than that in the non-enlarged group, and the proportion of SS occurring in mixed arterial phase and delayed fusion phase, as well as irregular hematoma shape, was higher than those in the non-enlarged group. The volume of hematoma on initial CT was larger in the enlarged group than that in the non-enlarged group (P＜0.05). Multivariate logistic regression analysis showed that SS score (OR=23.703, 95%CI: 1.336-420.556), hematoma volume (OR=1.618, 95%CI: 1.090-2.399), occurrence of SS in mixed arterial phase (OR=2.198, 95%CI: 1.164-4.152), and delayed fusion phase (OR=2.553, 95%CI: 1.363-4.781) were independent risk factors for HE (P＜0.05). Conclusion The volume of hematoma on initial CT, CTA SS score, and occurrence of SS in mixed arterial phase and delayed fusion phase are related to the occurrence of HE in patients with HICH.