功能磁共振对脑梗死后出血性转化预测.docVIP

功能磁共振对脑梗死后出血性转化预测 　　[摘要] 目的 探讨功能磁共振在脑梗死患者出血性转化中的预测价值。 方法 对44例脑梗死患者进行队列研究。所有患者均进行弥散加权成像（diffusion-weighted imaging，DWI）及灌注加权成像（perfusion-weighted imaging，PWI）检查。患者根据有无溶栓分为溶栓组20例，非溶栓组24例；根据有无出血性转化（hemorrhagic transformation，HT）分为HT组13例，非HT组31例。比较各自临床及功能磁共振上的特点。 结果 44例患者中，发生HT的患者共13例，占29.5%。其中溶栓组发生HT 8例，占40%。保守治疗组发生HT 5例，占20.8%。溶栓组PWI上相对局部脑血容量值（relative regional cerebral blood volume，rrCBV）较非溶栓组降低，差异有统计学意义（P = 0.037）。HT组入院时血糖、DWI上病灶体积、最低ADC值异与非HT组差异有统计学意义。 结论 脑梗死后HT是一个常见的并发症，溶栓治疗后发生率增加，功能磁共振可以预测溶栓后HT。 　　[关键词] 功能磁共振；出血性转化；溶栓；预测 　　[中图分类号] R743.3[文献标识码] A[文章编号] 1673-7210（2012）03（c）-0033-0 　　Prediction of hemorrhagic transformation after cerebral infarction by functional magnetic resonance imaging 　　LIN Xingjian1 SUN Feng1 CAO Hui1▲ LIU Wen2 XIAO Chaoyong2 　　1.Department of Neurology, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China; 2. Department of Radiology, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China 　　[Abstract] Objective To investigate the predictive value of functional magnetic resonance imaging in patients with hemorrhagic transformation after cerebral infarction. Methods A cohort study was completed with 44 cases of cerebral infarction patients. All patients underwent diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) examination. The patients were divided into two groups (thrombolysis group of 20 patients, non-thrombolysis group of 24 patients) according to whether thrombolytic was used. According to whether occurred hemorrhagic transformation (HT), the patients were divided into HT group of 13 cases and non-HT group of 31 cases. The features of clinical and functional magnetic resonance imaging were compared between different groups. Results In 44 patients, 13 cases occurred in HT, accounting for 29.5%. 8 cases in thrombolytic group occurred in HT, accounting for 40%. 5 cases in conservative treatment group occurred in HT, accounting for 20.8%. The relative regional cereb