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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 cerebral hemorrhage (HT) and micro-hemorrhage (CMBs) in acute cerebral infarction. Methods 72 patients with acute cerebral infarction confirmed by clinical and diffusion-weighted imaging (DWI) within 24 h were retrospectively analyzed. According to the presence or absence of extremely low signal in the infarct of SWI, Transformed group (HT group) and simple cerebral infarction group (control group). At the same time, CMBs were diagnosed as CMBs positive by 32 imaging doctors in 32 cases except 24 cases (24/62, 38.7%) in control group and 8 cases (8/10, 80%) in HT group. According to the distribution of CMBs, they were divided into brain lobe group and deep brain group. There were 8 cases (8/24, 33.33%) in the control group, 16 cases (16/24, 66.67%) in the deep brain. In the HT group, there were 7 cases (7/8, 87.5%) of the brain lobes and 1 case (1 / 8,12.5%) of the deep brain regions. Results The detection rates of the two groups of CMBs and the occurrence of site differences were statistically significant (P value <0.05). Conclusions The incidence of HT and CMBs after infarction is related to the site of occurrence. The detection of CMBs by SWI indicates the tendency of microvascular bleeding and predicts the risk of HT in acute phase, which may provide a possible basis for thrombolytic therapy.