李岩冰

DOI：10.16662/j.cnki.1674-0742.2017.07.178

[摘要] 目的 探讨颅脑CT和磁敏感加权成像在各型出血性转化中的临床诊断价值。方法 方便收集2012年2月—2016年10月该院收治符合纳入标准和排除标准的脑梗死患者126例，对颅脑CT和磁敏感加权成像的影像资料进行回顾性分析。结果 在HI1型患者中，颅脑CT出血灶的检出数量为27个，检出率19.05%，SWI检查的出血灶检出数量为73个，检出率为42.86%，颅脑CT在出血灶检出数量和检出率上均明显低于SWI检查差异有统计学意义（P<0.05）；在HI2、PH1和PH2型患者中，颅脑CT出血灶的检出数量分别为45、21和11个，检出率分别为34.13%、14.29%和7.14%，SWI检查出血灶的检出数量分别为48、23和11个，检出率分别为34.13%、15.87%和7.14%，颅脑CT和磁敏感加权成像扫描的检查结果差异无统计学意义（P>0.05）。结论 磁敏感加权成像可敏感的检查HT的早期微小出血灶，有较高的临床诊断价值，值得推广和应用。

[关键词] 出血性转化；颅脑CT；磁敏感加权成像；临床诊断

[中图分类号] R445 [文献标识码] A [文章编号] 1674-0742（2017）03（a）-0178-03

Comparison of Effect of Brain CT and Susceptibility Weighted Imaging in Hemorrhagic Transformation Diagnosis

LI Yan-bing

Department of Radiology， Tengnan Hospital of Zaozhuang Mining Group， Zaozhuang， Shandong Province， 277606 China

[Abstract] Objective To discuss the clinical diagnosis value of brain CT and susceptibility weighted imaging in various-type hemorrhagic transformations. Methods Convenient selection 126 cases of patients with cerebral infarction meeting the included standards and excluded standards in our hospital from February 2012 to October 2016 were selected and the imaging data of brain CT and susceptibility weighted imaging were retrospectively analyzed. Results For HI1-type patients， the detection number and detection rate of hemorrhagic foci of the brain CT were obviously lower than the SWI examination（27，19.05% vs 73， 42.86%），the difference was statistically sighificant（P<0.05）， for HI2-type， PH1-type and PH2-type patients， the differences in the detection number and detection rate of hemorrhagic foci between the brain CT and SWI had no statistical significance（P>0.05）. Conclusion SWI can sensitively test the HT early mini hemorrhagic foci with higher clinical diagnosis value， which is worth promotion and application.

[Key words] Hemorrhagic transformation； Brain CT； Hemorrhagic transformation； Clinical diagnosis

出血性轉化（hemorrhagic transformation， HT）是脑梗死患者中常见的并发症，在急性缺血性脑梗死患者中发病率最高，有着极高的病死率和致残率，因而受到越来越多的临床重视[1]。由于通过临床症状难以明确诊断HT，需及时和快速的影像学检查加以确诊。临床研究表明HT患者预后情况与是否得到及时诊治密切相关，如何及时并准确的检出HT成为影像诊断的关注热点[2-3]。目前临床上对HT影像学检查主要为颅脑CT扫描，最近有大量的临床研究报道磁敏感加权成像（susceptibility weighted imaging， SWI）在脑微出血、HT、颅内出血中均有较高的检出率而受到越来越多的临床应用[4-6]。……