BAT Score Versus Spot Sign in Predicting Intracerebral Hemorrhage Expansion

Objective: The BAT score is a novel prediction score of hematoma expansion based on noncontrast computed tomography (CT) and consists of the blend sign, hypodensities, and time interval from onset to CT. This study aimed to compare the BAT score and the spot sign on CT angiography in a cohort of patients with spontaneous intracerebral hemorrhage.

Methods: Eligible patients with spontaneous intracerebral hemorrhage were analyzed retrospectively. The BAT score and the spot sign were assessed according to the criteria described in previous studies. Receiver operating curve analysis was used to assess the performance of the BAT score and the spot sign in hematoma expansion prediction.

Results: In 225 included patients, 34 (15.1%) had a BAT score ≥3. The spot sign was shown in 68 (30.2%) patients. Hematoma expansion was identified in 56 (24.9%) patients. In multivariate analysis, both BAT score ≥3 and presence of spot sign were independently correlated with hematoma expansion. BAT score ≥3 had 0.41 sensitivity and 0.93 specificity, and spot sign had 0.64 sensitivity and 0.81 specificity. The area under the curve of BAT score ≥3 and area under the curve of spot sign were 0.673 and 0.727, respectively (P = 0.386).

Conclusions: The BAT score based on noncontrast CT is a good predictor of hematoma expansion. When CT angiography spot sign is unobtainable, the BAT score can be used to predict hematoma expansion.