论文部分内容阅读
目的研究MR弥散加权成像(DWI)对降纤治疗的脑梗死患者中出血性转化(HT)的预测价值。方法 309例接受降纤治疗的脑梗死患者进行DWI及T1WI、T2WI检查后分为出血性转化组(HT组)和非出血性转化组(NHT组);降纤治疗后2周内复查CT或MRI,比较两组DWI特点。结果 309例患者中,14例发生HT(4.5%),DWI可见病灶处信号降低,由高信号变为稍高混杂信号。与NHT组相比,HT组DWI上病灶面积大,最低ADC值及平均ADC值低(P<0.01)。多因素Logistic回归分析结果表明,DWI上病灶体积,病灶最大直径及最低ADC值是脑梗死患者降纤治疗后HT发生的独立危险因素。结论降纤治疗后,脑梗死患者HT发生率较低;DWI可以作为降纤患者HT的一个预测指标。
Objective To investigate the predictive value of MR diffusion weighted imaging (DWI) for hemorrhagic transformation (HT) in patients with cerebral infarction treated with fibrinolytic therapy. Methods 309 patients with cerebral infarction treated with fibrinolytic therapy were divided into hemorrhagic transformation group (HT group) and non-hemorrhagic transformation group (NHT group) after DWI, T1WI and T2WI. CT or MRI, DWI characteristics of two groups were compared. Results Among the 309 patients, HT (4.5%) occurred in 14 cases. DWI showed a decrease in the signal intensity of the lesion and a change from a high signal to a slightly higher promiscuous signal. Compared with NHT group, the area of DWI in HT group was large, the lowest ADC value and average ADC value were lower (P <0.01). Multivariate Logistic regression analysis showed that the volume of lesions, the maximum diameter of lesion and the minimum ADC value on DWI were independent risk factors for HT after defibrillation in patients with cerebral infarction. Conclusion The incidence of HT in patients with cerebral infarction is lower after defibrillators treatment, and DWI can be used as a predictor of HT in patients with fibrinolytic.