SWI在脑微出血与急性期脑梗死后出血转化的相关性研究  

The Value of SWI in Correlation Between Hemorrhagic Transformation After Acute Cerebral Infarction and Cerebral Microbleeds

作　　者：张丽雅[1] 朱平[1] 李华丽[1] 周旭峰[1] 高志翔[1] 卢超[1] 

机构地区：[1]郑州大学附属洛阳市中心医院磁共振室,洛阳471000

出　　处：《临床放射学杂志》2012年第7期918-921,共4页Journal of Clinical Radiology

摘　　要：目的探讨急性脑梗死脑出血转化(HT)与微出血(CMBs)的相关性。方法回顾性分析发病在24 h内经临床及扩散加权成像(DWI)确诊的急性期脑梗死患者资料72例,根据磁敏感加权成像(SWI)图像梗死灶内是否出现极低信号分为梗死后出血转化组(HT组)和单纯脑梗死组(对照组)。同时对病灶以外CMBs经两名影像学医师诊断记为CMBs阳性共32例,其中对照组24例(24/62,38.7%),HT组8例(8/10,80%)。根据CMBs分布分为脑叶组和脑深部组,对照组脑叶8例(8/24,33.33%),脑深部16例(16/24,66.67%)。HT组脑叶7例(7/8,87.5%),脑深部1例(1/8,12.5%)。结果两组CMBs检出率及发生部位差异均有统计学意义(P值<0.05)。结论梗死后HT与CMBs的发生率和发生部位相关,SWI可检出CMBs,预示微血管的出血倾向,预测急性期脑梗死HT的危险性,进而为溶栓治疗提供可能的依据。Objective To investigate the relationship between hemorrhagic transformation（HT） after acute isehemic in- farction and cerebral microbleeds （CMBs）. Methods Retrospective analysis of clinical and DWI confirmed acute stage of cerebral infarction within 24 hours of 72 patients was performed. According to whether there was hypointensity signal or not in the infarction on the SWI image, patients were divided into hemorrhagic transformation after infarction group（ HT group） and simple cerebral infarction group （ control group）. CMBs out of the lesion center was confirmed by two radiologists in 32 cases, among them, there were 24/62 cases in contral group（38.7% ） , 8/10 cases in HT group（80% ）. CMBs was divid- ed into the lobe of brain group and the deep brain group according to the CMBs distribution, 8/24 cases in lobe of brain group （33.33%）, 16/24 cases deep in brain group （66.67%） of the control group, 7/8 cases in lobe of brain group （87.5%） ,1/8 cases in deep brain group （ 12.5% ） of HT group. Results Both CMBs detection rate and the Occurrence of the two sets have statistical significance （ P 〈 0.05 ）. Conclusion The incidence and location of microbleeds have cor- relation with hemorrhagic transformation after acute cerebral infarction. CMBs can be detected by SWI, which can indicate the mierovascular bleeding tendency, predict the risk of hemorrhagic transformation after acute cerebral infarction, and then provide a possible basis for thrombolytic therapy.

关 键 词：磁敏感加权成像 急性期脑梗死 出血转化 脑微出血 

分 类 号：R743.3[医药卫生—神经病学与精神病学]