机械取栓术后CT高密度影发生机制的研究进展  

Research progress on the mechanism of CT high density imaging after mechanical thrombectomy

作　　者：王丹丹[1] 吕桦[2] 邸伟[2] Wang Dandan;Lyu Hua;Di Wei(Xi'an Medical University,Xi'an 710000,China;Department of Neurology I,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]西安医学院,710000 [2]陕西省人民医院神经内一科,西安710068

出　　处：《神经疾病与精神卫生》2022年第8期596-600,共5页Journal of Neuroscience and Mental Health

摘　　要：急性脑梗死患者机械取栓术后即刻平扫颅脑CT出现新发异常高密度影是临床常见的影像学表现。CT高密度影通常包括对比剂增强、对比剂外渗或脑出血,其中脑出血是较为严重的并发症。CT高密度影对患者最终梗死体积、颅内出血转化以及功能预后均具有一定的预测价值。CT高密度影的出现往往预示患者发生颅内出血转化的风险较高及预后不良(90 d改良Rankin量表≤2分)。CT高密度影的发生机制十分复杂,目前普遍认为CT高密度影的发生和发展与血脑屏障的破坏、应用抗凝药物、缺血再灌注损伤、介入器械对血管壁的损伤、对比剂的不良反应等诸多因素有关。探讨它们发生的相关机制对降低颅内出血的发生率及改善患者预后具有重要意义。现就急性脑梗死患者机械取栓术后CT高密度影发生机制的研究进展进行综述。It is a common clinical imaging manifestation that new abnormal high density image appears on brain CT immediately after mechanical thrombectomy in patients with acute cerebral infarction.CT high density imaging usually includes contrast enhancement,contrast extravasation or cerebral hemorrhage,among which cerebral hemorrhage is a more serious complication.It is found that CT high density imaging has certain predictive value on final infarct volume,intracranial hemorrhage transformation and functional prognosis.The presence of high-density CT images often predicts a higher risk of intracranial hemorrhage transformation and poor prognosis(90 d modified Rankin scale≤2 points).The occurrence mechanism of CT high density shadow is very complex and has not been fully understood.Currently,it is generally believed that the occurrence and development of CT high density shadow is related to the destruction of the blood-brain barrier,the application of anticoagulants,ischemia-reperfusion injury,the injury of vascular wall by interventional instruments,the toxic and side effects of contrast agents and many other factors.It is of great significance to explore the related mechanisms of intracranial hemorrhage to reduce the incidence and improve the prognosis of patients.This paper reviews the research progress on the mechanism of high density imaging after mechanical thrombectomy in patients with acute cerebral infarction.

关 键 词：机械取栓术 CT 高密度影 发生机制 综述 

分 类 号：R651.1[医药卫生—外科学]