SWI对急性缺血性脑卒中出血性转化的检测及其对预后的影响  

Detection of hemorrhagic transformation in acute ischemic stroke by SWI and its prognostic value

作　　者：王林魁 温琥玲[2] 杨凡慧 WANG Lin-kui;WEN Hu-ling;YANG Fan-hui(Department of Radiology,Wuhu Fifth People s Hospital,Wuhu 241000,Anhui;Department of Nuclear Medicine,Affiliated Hospital of North Sichuan Madical College,Nanchong 637000,Sichuan,China)

机构地区：[1]芜湖市第五人民医院放射科,安徽芜湖241000 [2]川北医学院附属医院核医学科,四川南充637000

出　　处：《川北医学院学报》2021年第8期968-970,998,共4页Journal of North Sichuan Medical College

基　　金：四川省科技厅科研项目(2021YJ0515)。

摘　　要：目的:探讨磁共振磁敏感加权成像(SWI)技术用于急性缺血性脑卒中(AIS)出血性转化(HT)检测的敏感性及不同HT面积对临床预后的影响。方法:选取90例接受静脉溶栓救治的AIS患者作为研究对象,均给予SWI检查和颅脑CT检查;观察两种检查技术的HT检出情况及不同HT面积对患者神经缺损的影响。结果:SWI检查溶栓后发生HT的总检出率为42.22%(38/90),其中HI-1型比例最高(26.67%,24/90);头颅CT检查发生HT总检出为27.78%(25/90),其中HI-1型所占比例为(14.44%,13/90),与SWI总检出率和HI-1型检出率之间的差异均存在统计学意义(P<0.05);SWI检查出血面积大于CT检查(P<0.05);大出血组患者出院时NIHSS评分为(50.15±5.24)分,高于入院时的(34.52±3.26)(P<0.05);微小出血组患者出院时NIHSS评分为(30.25±2.60)分,低于入院时(35.83±3.65)(P<0.05);出院时微小出血组患者NIHSS评分相比大出血组显著更低(P<0.05)。结论:SWI技术用于AIS患者静脉溶栓后HT诊断,可较好地识别微小出血,检出效果较理想,对HT出现面积的判断也较准确;另外,出血面积越大,AIS患者的预后也越差。Objective:To evaluate the effect of susceptibility weighted imaging(SWI)in detecting hemorrhagic transformation(HT)in patients with acute ischemic stroke(AIS)and the influence of different HT areas on prognosis.Methods:90 patients with AIS who received intravenous thrombolysis were selected as the research objects.SWI and CT were performed in all patients.The detection of HT and the nerve defect of the patients with different HT area were observed.Results:The total detection rate of HT was 42.22%(38/90)in SWI,of which HI-1 was the highest(26.67%,24/90),and HT was 27.78%(25/90)in head CT,of which HI-1 was 14.44%(13/90),the differences were statistically significant(P<0.05).The bleeding area of SWI was significantly larger than that of CT(P<0.05).The NIHSS score of the hemorrhage group was(50.15±5.24),which was significantly higher than that of the admission group(34.52±3.26,P<0.05).The NIHSS score of patients in the microbleeding group was(30.25±2.60)at the time of discharge,which was significantly lower than(35.83±3.65)at the time of admission(P<0.05).The NIHSS scores of patients with minimal hemorrhage at discharge were significantly lower than those of patients with severe hemorrhage(P<0.05).Conclusion:SWI technique for diagnosis of HT after intravenous thrombolysis in AIS patients can obviously improve the ability of identification of micro-hemorrhage,obtain the ideal result of detection and the accurate result of area judgment.The bigger the area of hemorrhage,the worse the prognosis of AIS patients.

关 键 词：急性缺血性脑卒中 静脉溶栓 出血性转化 磁共振磁敏感加权成像 CT检查 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]